HomeMy WebLinkAbout2002- April File Copy
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Jefferson County
Board of Health
Agenda
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Minutes
April 18, 2002
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JEFFERSON COUNTY BOARD OF HEALTH
Thursday, April 18, 2002
2:30—4:30 PM
Main Conference Room
Jefferson Health and Human Services
AGENDA
I. Approval of Agenda
II. Approval of Minutes of Meetings of March 21, 2002
III. Public Comments
IV. Old Business and Informational Items
1. Environmental Health Survey
2. Results on BRFSS Update
- Environmental Health Questions
III - 18-34 Year Olds Health
3. Letter to School Superintendents
-Washington State Healthy Youth Survey (2002)
V. New Business
1. Review of Assessment Workgroups Geoff/Roberta
- Access to Care
- Childhood History of Violence
- Concentration of Risk in Households with Children
2. Washington State Bioterrorism Plan— Tom
Jefferson County Impacts
3. Legislative Wrap-Up Tom
4. Joint Board Meeting with Jefferson General Hospital
VI. Agenda Planning
V. Adjourn
Next Meeting: May 16, 2002 2:30 PM—4:30 PM
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JEFFERSON COUNTY BOARD OF HEALTH 4te
MINUTES
• Thursday, March 21, 2002 dt)'
Board Members: StaffMembers:
Dan Titterness,Member-County Commissioner District#1 Jean Baldwin,Nursing Services Director
Glen Huntinord,Member-County CommissionerDistrict#2 Larry Fay,Environmental Health Director
Richard Wojt,Member-County Commissioner District#3 Thomas Locke,MD,Health Officer
GeoffreyMasci, Vice-Chairman-Port Townsend City Council
Jill Buhler,Member-Hospital Commissioner District#2
Sheila Westerman, Chairman- Citizen at Large(City)
Roberta Frissell- Citizen at Large(County)
Chairman Westerman called the meeting to order at 2:30 p.m. All Board and Staff members were
present, with the exception of Commissioner Wojt.
APPROVAL OF AGENDA
Member Masci moved to approve the Agenda. Commissioner Titterness seconded the motion,
which carried by a unanimous vote.
APPROVAL OF MINUTES
Member Masci moved to approve the minutes of February 21, 2002 with one correction to page
• one, paragraph one, which should state"Chairman Westerman called the meeting to order"rather
than "Chairman Buhler."Member Buhler seconded the motion, which carried by a unanimous vote.
PUBLIC COMMENT—None
OLD BUSNESS AND INFORMATIONAL ITEMS
Complaint Response Procedure: Commissioner Titterness inquired about the status of the
Complaint Response Procedure. Larry Fay said Risk Management is reviewing the document,with
the County Prosecutor doing a final review. He agreed to follow-up with Deputy County Prosecutor
David Alvarez.
NEW BUSINESS
2002 Legislative Session Report—Bills,Backfill, Bonds And Bioterrorism: Dr. Tom Locke
reported that a number of bills will have significant, but not immediate impacts dealing with
changes in health care codes and the roles of local Boards of Health, and can be dealt with by the
Board over time. Most surprising to report is that backfill funding will remain through June 2003.
This means the County will not have to dismantle about 50% of communicable disease control
capabilities in the State. Even though the State remains in crisis because funding will not continue
past the end of the biennium, there will be additional time to come up with a more comprehensive,
stable funding source for essential public health services. Local public health people are working
hard on a federal bioterrorism plan to make Washington State eligible for $20 million a year in
• federal bioterrorism preparedness funds, the deadline of which is one month away.
Commissioner Huntingford asked whether the $20M earmarked for Washington State would fill
some of the other funding gaps?Dr. Locke explained that almost no federal money could be
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HEALTH BOARD MINUTES —March 21, 2002 Page: 2
• transferred or used to fund other areas of public health. Although it was originally thought that these
funds would go to the State for distribution, the Federal guidelines are 80% local, 20% State and
any state-wide plan has to have the consultation and endorsement of local health.
Jefferson County Behavioral Risk Factor Surveillance System (BRFSS) Report: Jean Baldwin
recognized that funding for this study came from the City and the Health Department.
Dr. Chris Hale then provided background on the BRFSS, which is designed and carried out by the
Centers for Disease Control. She explained how the survey was administered, noting the remarkably
high success rate of 80% to the 170-question survey. After explaining how the data is organized,
she summarized the findings under the following six message statements:
1. Adults in Jefferson County generally enjoy better health than the State average.
• Life expectancy is consistently higher than Washington State— 79 years as opposed to 77.
• On the self-reported health status, Dr. Hale noted the Fair/Poor response is high and comes
from the 18-34 age range. She noted this is one of the first indicators that this age group
looks different from the rest of the County—and not in a good way.
• Of the first standard quality of life indicators, physical health looks similar to the State
average and mental health looks better than the State. In terms of adult health, indicators
look very good.
2. Adults in Jefferson County generally have as good or better access to health care as the
State average.
• • Ninety percent of the adult population has some kind of health insurance. This varies
dramatically by age, with the 18-34 year olds most often without health care coverage.
• While 85%reported they have a person they go to for medical care, no question asked how
far they have to travel to see that doctor. Commissioner Huntingford suggested that it might
be interesting to review bridge closure information from the Department of Transportation
to try to answer this question.
• Eighty-eight percent indicated they had a place they could go if they were sick or needed
health advice.
• The percentage of those seeing a doctor in the past year for a routine check-up—75%—was
significantly higher than the State average of 68%. Vice-Chairman Masci noted that the
remaining 25% are those who are served by public health.
• Although 29%have been told they have high blood pressure, compared with the State
average of 22%, when compared with age-specific rates there is no difference.
• Sixty-seven percent reported they have used a home blood stool test kit, as opposed to 41%
of the State.
• Seventy-two percent of the adults made a dental visit in the last year, compared with 67% of
the State. The exception is the 18-34 year olds.
3. In general, among Jefferson County adults, rates of behaviors that predict good health are
higher, and rates of behaviors that predict poor health are lower.
• • In this County, only 16% of adults now smoke, which is significantly less than the State
(21%) or Kitsap County (23%).
HEALTH BOARD MINUTES —March 21, 2002 Page: 3
• • Twenty-nine percent consider themselves at risk for health problems related to being
overweight as compared with 36% seen for the State.
• Only 13% reported being at risk for health problems associated with physical inactivity,
compared with 27% of the State. In line with the new guidelines to be physically active at
least 5 days a week for at least 30 minutes a day, surprisingly, 87% of those who are
physically active are active at that recommended rate.
• Thirty-four percent of those considered heavy drinkers also currently smoke. There was also
a strong association between heavy drinking and being overweight.
4. Jefferson County's drinking patterns are different from the State.
• Sixty-eight percent consumed alcohol in the past 30 days, compared with 61% in the State.
• A larger proportion of men than women consumed alcohol. However, for both men and
women, consumption was significantly higher than the State.
• The more years of education, the more likely you are to drink alcohol. Jefferson County is
extremely well educated.
• When looking at alcohol consumption over the last 30 days, Jefferson County is very
different from the State. Those consuming 1-5 days per month was 49% as opposed to 60%
in the State, those consuming 6-10 days and 11-20 days were similar to the State
percentages, but 24% said they consumed alcohol 20 days or more, compared with 8% of
the State. Most of that 24% consumed alcohol 30 of the past 30 days. These rates are similar
• with European drinking patterns.
• Of those respondents who drink, men drank 14 out of the last 30 days, and women drank 9.1
out of 30. The average number of drinks consumed per day was 1.7—males drank an
average of 2.0 drinks per day while women drank 1.5 drinks.
• Seventeen percent of County adults were heavy drinkers, which is significantly lower than
that for the State, 23%.
5. County residents report higher rates of childhood abuse than the State average, and this
abuse affects their adult functioning. Dr. Hale prefaced this data by saying that for some time
there has been concern in the public health community about domestic violence and
considerable concern about the life-long effects of children seeing violence. She noted that
when asking about current experience with violence, the rates were so low the data was not
usable.
• The percentage of those saying they were punished violently was 9%, slightly higher than
the State response of 7%.
• Twelve percent reported being sexually abused before the age of 18, compared with 9% in
the State.
• To the question of whether they saw a parent or guardian abused, 11% answered yes.
• 25%reported having seen or experiencing physical or sexual abuse, compared with 20% in
the State, which is statistically significant.
• People younger than 65 were more likely to report abuse than 65 and older.
HEALTH BOARD MINUTES —March 21, 2002 Page: 4
• • Those with four plus years of college reported being physically abused at lower rates than
those with under 4 years.
• Women in Jefferson County were more likely to report sexual abuse than men. 18% of
women reported sexual abuse, compared with 14% in the State.
• People with childhood histories of any abuse reported, on average, more days of poor health
in the previous 30 days than people without such histories.
Vice-Chairman Masci mentioned that these statistics can also become predictors of not only
medical health needs, but law and justice needs.
6. Households with children younger than 18 have unusually dense concentrations of adults
who reported health care access problems and who smoke,drink heavily, and themselves
have childhood histories of abuse. Dr. Hale said the goals of Healthy People 2000 are
"optimizing life expectancy, optimizing quality of life and to reduce disparities."Populations
that have been identified as being radically different from the rest of the population are
households with children under the age of 18 and the 18-34 age group. In data yet to be
analyzed, there are some indications that these groups are not only different from other citizens
of the County, but are different than others of the same age groups in the State.
Dr. Hale summarized the survey findings by saying households in Jefferson County with children
under 18 are disproportionately likely to have adults in those households who have abuse histories.
She noted the maternal child health indicators in Jefferson County remind her of Cowlitz County,
• which has some of the worse health rates in the State. She recognized the expense of the survey
($25,000 - $32 per respondent for data collection alone) and said the data should be useful over the
next five years. She added the 18-34 age group information is expected within a week.
Vice-Chairman Masci commented that he believes the project was a good investment. Other data
can now be compared with this fundamental database to make knowledge-based policy decisions.
Dr. Hale mentioned that Kellie Regan is now trained to do an in-house study and could create a sub-
base of questions.
Member Frissell pointed to the need for data on the jail population and school age children.
Jean Baldwin said the next projects listed on the Data Steering Committee report are the prenatal
risk assessment survey of all county residents giving birth in 2002, a jail survey and school district
survey. Dr. Hale added that the prenatal risk survey will be largely based on the survey of women
who gave birth and include three questions of the respondent's childhood experience of abuse. Ms.
Baldwin said that four out of five school districts will participate. She noted that the data from the
survey can only be released on a county-wide basis. However, schools will have their data to release
if they so choose.
In response to questions from Commissioner Huntingford about the ages of children to be surveyed
and whether students could opt out, Kellie Regan explained that the health needs survey is for 6th,
8th, 10th and 12th grades, and she believes it is a passive parental consent, which provides an
opportunity to exempt the child.
The Board was impressed with the depth of analysis and thanked Dr. Hale, Jean Baldwin and Kellie
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Regan for an incredible job.
Vice-Chairman Masci and Jean Baldwin then proposed convening a series of workgroups as a way
of presenting this information to others in the community(e.g. law and justice, healthcare providers,
HEALTH BOARD MINUTES—March 21, 2002 Page: 5
senior services). Chairman Westerman asked that Staff propose a list of workgroups, so the Board
• can discuss it at the next meeting.
Chairman Westerman and Member Buhler talked about their personal experiences as respondents in
the telephone survey. They said interviewers were friendly, professional, and nonjudgmental.
Chairman Westerman commented that this is the first time since she has been on the Board there
has been good, dependable information despite steadily dwindling resources. It is important to
commit to continuing this process because the situation will get increasingly difficult and the
number of those at risk groups is going to rise as resources go down. She encouraged the
Commissioners to continue with this process, recognizing that as they make difficult decisions, it
will be vital to have valid information with which to face difficult policy choices.
Vice-Chairman Masci moved that the Board of Health request that the County
Commissioners authorize expansion of this process to a jail survey, the structure and format
of which would be recommended through a team of Jean Baldwin, Kellie Regan and Dr. Hale.
Member Frissell seconded the motion.
Dr. Hale said she has insisted that any data collection has to be vetted by an institutional review
board. With the particular precautions around a jail population, such action would be absolutely
necessary before they could get the work done.
Vice-Chairman Masci noted that because the existing data is paid for, the cost for this small
additional component would be minimal. Due to City/County policy making and the cost of
criminal justice, he stressed the importance of making good decisions and having good data on
which to make those decisions.
The motion carried. Commissioners Huntingford and Titterness abstained.
Vice-Chairman Masci moved that the Board send a letter to the four school districts
encouraging them to participate in the health needs survey. Jill Buhler seconded the motion,
which carried by a unanimous vote.
Prenatal Risk Assessment Monitoring (PRAMS): Jean Baldwin reported that Staff has met with
both the hospital and the State and have come to agreement on the questions to be asked. The
hospital's financial support of the assessment will be encouraged. On April 2, the Environmental
Health customer satisfaction survey will begin and will include customers, realtors and designers.
Regarding maternal child health, Staff is in the process of a lengthy review of the Best Beginnings
Project which in July will reach the end of the 3-year contract with the University of Colorado.
There will be some chart review and evaluation of Family Planning to see if it is filling the access
need for those 1,300 served, the majority of whom are 18-34. Dr. Hale will be presenting the
BRFSS data at a Substance Abuse Committee community training session for the public and
professionals on April 30th looking at Methamphetamine treatment strategies.
Chairman Westerman commented that the expanded Board is a perfect opportunity to de-politicize
community and environmental health issues.
Members Frissell and Buhler both spoke in favor of the County Commissioners using the Board as
a resource.
Commissioner Huntingford said his biggest fear with the expanded Health Board was that the
• County Commissioners would make decisions based on a broader knowledge of what is going on in
Jefferson County. While the Board of Health may someday be upset that the County Commissioners
did not listen fully to their recommendations, he believes the Board understands better the issues
HEALTH BOARD MINUTES—March 21, 2002 Page: 6
with which the County Commissioners faced such as the difficult decisions about whether to lay off
ill people or add new programs. He spoke in favor of the BRFSS as a good investment.
Pull Tab: Commissioner Titterness reported that a representative group showed up at the County
Commissioner hearing to speak on the issue and share their perspective. They commented that there
was not enough profit to take the full amount of the tax allowed. The County Treasurer also
researched the topic with another County and found that when the tax was implemented—about
40%who were in the business of pull tabs got out. The issue was sent back to Gary Rowe for a
recommendation. Vice-Chairman Masci said the City Council has yet to discuss the matter.
Chairman Westerman said although it is never easy to begin, it is something to consider if it
provides a steady funding source for a program for a needy population. She said the Board could
provide more support for the County Commissioners if desired.
AGENDA PLANNING/ADJOURN
April Agenda Topic: Review the 18-34 year old BRFSS data.
Joint Board Meeting: Dr. Locke explained that Staff is trying to schedule a joint meeting with the
Hospital Commissioners. After the last meeting, the Board of Health was going to work on critical
health services, deciding what are the essential services and looking at the data collected to see what
information it provides. The Hospital was focused on patching gaps in health services. The biggest
goal is to get organized for the next health summit. Staff will continue to try to coordinate a
meeting.
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The meeting adjourned at 4:40 p.m. The next meetingwill be held
on Thursday, April 18, 2002 at
2:30 p.m. at the Jefferson County Health and Human Services Conference Room.
JEFFERSON COUNTY BOARD OF HEALTH
Sheila Westerman, Chairman Jill Buhler, Member
(Excused)
Geoffrey Masci, Vice-Chairman Richard Wojt, Member
Glen Huntingford, Member Roberta Frissell, Member
Dan Titterness, Member
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Board of Health
Old Business
Agenda Item # IV., 3
• Letter to School
Superintendents
April 18 , 2002
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DRAFT
April 11, 2002
TO: Chimacum, Port Townsend Brinnon, and Quilcene School Superintendents
FROM: Jefferson County Board of Health
Sheila Westerman, Chair
SUBJECT: 2002 Healthy Youth Survey
This is a letter of encouragement for Chimacum, Port Townsend, Brinnon, and Quilcene
Schools to participate in the 2002 Healthy Youth Survey (HYS).
In a recent Board of Health meeting, members were informed of a unique opportunity that
Jefferson County schools can take advantage of—the 2002 HYS.
The 2002 HYS can provide useful assessment data. Survey results will tell districts about:
• • health risk behaviors of our community's youth in areas including nutrition, physical
activity, violence, alcohol, tobacco and other drug use.
• attitudes and opinions of youth—and research shows correlations between attitudes and
risk behaviors.
The 2002 HYS findings can
• Identify and monitor factors that affect Jefferson County youth
• Guide program and policy development in conjunction with the principles of
effectiveness
• Assist many local agencies with programs which focus on youth and families
• Complement the current comprehensive county assessment process, which includes
Behavioral Risk Factor Surveillance Survey (BRFSS), Census 2000, law and justice
records, and vital statistics.
In Jefferson County, Kellie Ragan of Jefferson County Health & Human Services is the contact
for the 2002 HYS. She can provide additional details about the survey, its administration, the
HYS instrument and data analysis. Please contact her at 360-385-9446 for additional
information about the survey.
In this time of shrinking dollars, we must take full advantage of the use of data to make
responsible decisions. The 2002 HYS findings can provide a beacon to assist in responsible
planning efforts. Therefore, we strongly encourage each district in our community to commit to a
census survey, that is–survey each student in grades 6, 8, 10 and 12.
• In advance, thank you for your consideration of this effort.
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Washington State
Healthy Youth Survey (2002)
Rationale and Description of Survey Content
The 2002 Washington State Healthy Youth Survey contains questions about
behaviors that result in unintentional and intentional injury (e.g., seat belt use,
fighting and weapon carrying); physical activity and dietary behaviors (e.g., fruit
and vegetable consumption), alcohol, tobacco, and other drug use; and
related risk and protective factors. Staff from the Office of Superintendent of
Public Instruction (OSPI), the Department of Health (DOH), the Department of
Social and Health Services' Division of Alcohol and Substance Abuse (DASA),
and the Office of Community Development (OCD) have collaborated on the
content of the survey.
The survey has two forms for grades 8, 10 and 1 2, Form A and Form B. Form A
contains primarily questions from the Washington State Survey of Adolescent
Health Behavior (WSSAHB). Form B contains primarily questions from the Youth
Risk Behavior Survey (YRBS). Both Forms A and B contain a core set of 32
identical items. There is also a third form, Form C, for grade 6. Examples of
• questions below are on one or more of the forms.
This document describes the importance and rationale for including each of
these health behaviors on the survey and presents a few sample items from the
survey relating to each behavior.
Questions about family relationships, harassment, dating violence, and abuse
history will be on a perforated page that can be torn off before survey
administration, and this page is marked on the draft questionnaire. Examples of
the questions are included below, but they are optional. Students are also free
to not answer any question or questions, and both students and parents will
have an opportunity to refuse participation.
Core Items
Some basic background information (e.g., age, grade level, ethnic group, etc.)
is needed to ensure that the approximately 20,000 students participating in the
state sample are generally representative of the statewide student population in
these grades. In addition, it allows for examination of trends and differences in
these behaviors among students of varying background characteristics.
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Healthy Youth Survey (2002) 1 November2002
Other core items measure cigarette smoking, drug and alcohol use, and
• physical fighting. Tobacco use is considered the most important preventable
cause of death in the United States, and many smokers begin smoking in
adolescence. Alcohol use contributes to motor vehicle crashes, which are the
leading cause of death for 15-24 year olds. Both alcohol and drug use
(especially heavy use) are associated with other problem behaviors in youth
such as school failure and delinquency. After all deaths due to unintentional
injury, suicide was the second and homicide the third leading cause of death
among Washington youth aged 15-24 during 1996-1998.
Data from the Healthy Youth Survey can be used in local and state prevention
and intervention program planning. Also, data will be available to legitimate
researchers and educational and health officials to use in improving our
understanding of factors influencing adolescent health.
All analyses are conducted without specific identification of individual students
so that anonymity is maintained throughout the survey effort. In order to further
protect student anonymity, reports will not be produced for schools with less
than 15 valid surveys per grade.
Sample items of this type include:
• What grade are you in?
How old are you?
Which race do you consider yourself to be? (???)
During the past 30 days, on how many days did you smoke
cigarettes?
During the past 30 days, how many times did you carry a weapon
such as a gun, knife or club on school property?
Unintentional and Intentional Injury Behaviors
Unintentional injury is the leading cause of death for Washington citizens ages 1-
44. Some of the target behaviors of interest in this survey are seat belt use,
bicycle and motorcycle helmet use, and drinking and driving involvement.
Intentional injury behaviors of interest include fighting, weapon carrying, and
suicidal thoughts and feelings. The questions on feeling sad and suicidal are
especially important to measure the effectiveness of suicide prevention
programs. Suicide is the 2nd leading cause of death among 15-24 year olds. The
questions on injury behaviors are drawn from the WSSAHB (Form A) and the YRBS
• (Form B); as noted earlier, some of these items are on the core.
Healthy Youth Survey (2002) 2 November 2002
Reducing violent behaviors such as bullying, harassment, physical abuse, and
• dating violence is an important goal of state and local programs. Current
federal and state goals for public health and education include the assurance
of "safe and drug-free schools and communities" to promote student learning.
This survey includes questions designed to determine the extent to which
students engage in selected violent behaviors.
Sample items of this type include:
During the past 30 days, how many times did you drive a car or
other vehicle when you had been drinking alcohol?
How often do kids at school threaten to hurt you physically?
During the past 12 months, did you ever feel so sad or hopeless
almost every day for two weeks or more in a row that you stopped
doing some usual activities?
Physical Activity and Dietary Behaviors
Exercise and physical activity have both immediate and long-term benefits.
Proper nutrition is essential for health and well-being. The combination of
• moderate physical activity and proper nutrition contributes to maintaining a
healthy weight.
Questions from the YRBS are used to measure exercise and physical activity.
Sample items of this type include:
On how many of the past 7 days did you exercise or participate in
physical activity for at least 20 minutes that made you sweat and
breathe hard, such as basketball, soccer, running, swimming laps,
fast bicycling, fast dancing, or similar aerobic activities?
During the past 7 days, how many times did you eat green salad?
Alcohol, Tobacco, and Other Drug Use
One of the target behaviors of interest in this survey is the extent to which
students have used and are using alcohol, tobacco, and other drugs. Many of
the same items that have been used in the previous statewide surveys will again
be employed here. Asking these questions again allows for both local and
statewide assessments of the changes in these patterns of use over time for
Washington's students and provides important data-based direction for
• prevention efforts both locally and across the state.
Healthy Youth Survey (2002) 3 November2002
Sample items of this type include
41/
Have you ever smoked every day days?
for 30 da s?
During the past 30 days, on how many days did you drink a glass,
can or bottle of alcohol (beer, wine, wine coolers, hard liquor)?
Risk and Protective Factors
Research has provided a great deal of guidance on attitudinal and behavioral
factors that place students at great risk for violence and substance use, and
those that, on the positive side, provide protection against these unhealthy
behaviors. The survey contains several items that assess the degree to which risk
and protective factors occur in the students who have responded to the survey.
They relate to the students themselves, their peers, their families, their schools,
and the communities in which they live. These results highlight the important
relationships that guide school prevention and intervention programs across the
state.
Sample items of this type include:
How wrong do you think it is for someone your age to smoke
illmarijuana?
How interesting are most of your courses to you?
How old were you when you first smoked a whole cigarette?
How often do your parents tell you they're proud of you for
something you've done?
Access to school-based services
Schools are increasingly seen as an important place for students to be able to
access a variety of services. When schools do provide these services, students
must also be aware that they are available. Therefore, the survey contains
questions related to access to school-based services.
Sample items of this type include:
Does your school provide a counselor, intervention specialist, or
other school staff member for students to discuss problems with
alcohol, tobacco, or other drugs?
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Healthy Youth Survey(2002) 4 November2002
If you had a question about alcohol, tobacco, or other drugs, which
one of the following would you most likely go to for information?
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Healthy Youth Survey(2002) 5 November 2002
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WASHINGTON STATE HEALTHY YOUTH SURVEY (2002)
FACT SHEET
February 2002
In fall 2002 the Office of Superintendent of Public Instruction (OSPI), the
Department of Health (DOH), the Department of Social and Health Services'
Division of Alcohol and Substance Abuse (DASA), and the Office of Community,
Development (OCD) will conduct a survey to measure adolescent health
behaviors and related risk and protective factors among Washington's Grade 6,
8, 10, and 12 students in public schools. This fact sheet answers important
questions about the Healthy Youth Survey.
Q: What is the focus of the Healthy Youth Survey?
A: The focus of the Healthy Youth Survey is on health risk behaviors—such
as violence and alcohol, tobacco and other drug use—that can result in
injury and/or impede positive development among youth. The survey also
includes questions about risk and protective factors, which are attitudes
and opinions that research has shown to be correlated with these risk
.
behaviors.
Q. How does the Healthy Youth Survey compare to surveys that have
been administered in the past?
A. The Healthy Youth Survey combines two surveys used previously, the
Washington State Survey of Adolescent Health Behavior (WSSAHB) and the
Youth Risk Behavior Survey (YRBS). To accommodate a large number of
items, the questionnaire for grades 8, 10 and 12 has two forms, A and B.
The forms (A and B) will be interleaved before they are sent to the schools
so that when they are passed out every other student will get a different
form. Both forms have a "core" set of 32 items that are identical for the
two forms. The last page on each form is a perforate answer sheet.
Questions that are potentially sensitive have also been put on a
perforated page (the second to last page), although they are important
for planning and evaluation of programs that serve youth. Schools must
make the decision to tear off the perforated page of questions before the
survey is administered in the classroom. All students in grade 6 will receive
a shorter questionnaire, form C. This form includes the perforated page of
questions that schools may choose to tear off prior to survey
administration.
• Q: Why is the survey conducted?
Healthy Youth Survey(2002) 1 November 2001
• A: The purpose of the survey is to identify and monitor factors that affect
the health of youth in Washington. Since similar surveys have been
conducted across the state in 1988, 1989, 1990, 1992, 1995, 1998, 1999, and
2000, its results can be used to monitor how health behaviors change over
time. The results can also be used to identify important areas of need for
prevention programs.
Q: Do all Washington students take the Healthy Youth Survey?
A: No, only a sample of students in Grades 6, 8, 10 and 12 take the survey.
Schools are selected across the state to provide a representative sample
of the entire student population at these grades. In all, about 125 schools
and 20,000 students will participate—approximately 6 percent of the
student population at these grade levels.
Q: Does my school have to participate?
A: Participation in the survey is voluntary. However, broad participation for
all of the schools selected in the sample is needed to obtain accurate
estimates of these behaviors.
Q: Why should my school participate?
• A: This survey provides important information about adolescents in
Washington, which can be used to guide policy and programs, and to
focus attention on the needs of youth. Where numbers are adequate to
protect privacy and provide accurate estimates, schools will be provided
with a summary report of the results for their school, along with statewide
totals for comparison. Schools will receive results for questions that have at
least 15 valid responses per grade. This information is provided at no cost
and is very useful in guiding prevention program planning and in fulfilling
data requirements for programs led by county prevention coordinators,
community mobilization coalitions, community public health and safety
networks, and others. Schools decide whether to receive their results at
the time the statewide results are released, or not at all.
Q: Can my school participate if it is not selected for the sample?
A: Yes, there is an opportunity for additional schools to participate and
receive the results of the survey. The sponsoring agencies have agreed to
cover the cost of piggybacking onto the survey, using DOH tobacco
prevention dollars. A piggyback request form is available from RMC
Research Corporation and must be completed for a school to participate
as a piggyback.
• Q: Are sensitive questions asked?
Healthy Youth Survey(2002) 2 November 2001
• A: The survey questions measure key behaviors and some of the questions
are sensitive. The survey includes questions related to unintentional and
intentional injuries; physical activity and dietary behaviors; alcohol,
tobacco, and other drug use; and related risk and protective factors.
Unless questions in these topic areas are asked honestly and
straightforwardly, we cannot know the degree to which Washington's
youth engage in these health risk behaviors. The survey does not include
questions about sexual behavior or education. Certain sensitive questions
have been included on a separate page.
Q: Is student participation voluntary? Are answers anonymous?
A: Student participation is completely voluntary and anonymous and the
administration procedures are designed to protect student privacy and
anonymity. Students are not asked for their names or identification
numbers when they complete the survey. When they finish the survey,
students place their completed survey in a box or envelope with no
personal identifiers. The box or envelope of completed surveys is then
sealed and shipped to the contractor for optical scanning and analysis.
Students may elect to participate in an alternative activity if they do not
wish to complete the survey.
• Q: How is the survey coordinated at each school?
A: Each participating school has a designated survey coordinator, and
each school district or ESD has a central coordinator for the survey effort.
These spokespersons and coordinators have additional information on the
survey, its administration instructions, and uses of the results.
Q: Can I review the survey?
A: Yes, a copy of the survey is available in the office of each school.
Q: How long does it take to fill out the survey?
A: One class period is needed to complete the survey. All questions are
self-report and no physical tests or exams are involved.
Q: Do students answer the questions truthfully?
A: Both national research and the experience in Washington indicate that
the data collected are generally accurate when students are told of the
importance of the information and that their responses are completely
anonymous. Internal reliability checks help identify any surveys which
have obviously been answered carelessly and these surveys are
• discarded from the sample. In addition, students always have the option
Healthy Youth Survey(2002) 3 November 2001
. of not answering questions to which they do not feel comfortable
responding.
Q: When is the survey conducted? When are results available?
A: The survey will be administered during October 7-18, 2002. Results will
be available in mid-February, 2003.
Q: How will this information be used?
A: Information from the Washington State Healthy Youth Survey can be
used to meet a variety of needs at the community and state levels.
The survey provides information that can be used to identify the
importance of various problem behaviors. This information can be used as
input for resource and policy decisions, such as targeting interventions.
Those who receive the information may choose to share it with other
community organizations. The items that were asked in previous years can
be used to identify trends or changes in the patterns of behavior over
time. The state-level data can be used to compare Washington results to
other states that do similar surveys and to national results. Legitimate
researchers and educational and health officials will have access to the
data. At the state and federal levels, there are a variety of competing
• interests for limited resources. Results of this survey can be and have been
used to provide evidence for the high priority of the important issues
identified.
Healthy Youth Survey(2002) 4 November 2001
•
Board of Health
New Business
Agenda Item # V. , 2
Washington State
• Bioterrorism Plan -
Jefferson County Impacts
April 18, 2002
•
Executive Summary
CDC Public Health Preparedness and Response for Bioterrorism
• Work Plan
Purpose: The Washington State Department of Health (DOH) is submitting a work plan for
approval to HHS for funding to develop capacity and infrastructure for public health
preparedness and response to bioterrorism. The primary focus of this stage of funding is
assessment and planning. Capacity building is proposed where planning has already been
accomplished. The ultimate purpose of the work is to build a statewide system with state and
local public health jurisdictions prepared for and able to respond to acts of bioterrorism, other
outbreaks of infectious disease, public health threats and emergencies.
Background - The challenge of preparing for and responding to a biological event is significant.
Unlike the events of September 11, 2001 or other acts of overt violence, infectious disease
outbreaks are often difficult to identify early on. There is no explosion or outward sign. Instead
there is an ever-increasing number of individuals showing up at clinics, emergency rooms and
health care provider offices. The illnesses may be scattered geographically and occur in a
number of different jurisdictions at once, depending on source and mechanism of initial
infection. Without methods to rapidly detect this manifestation throughout the health system, an
effective response cannot be mounted in a timely and coordinated fashion. The introduction of
bioterroism agents adds another layer of complexity, due to the lack of experience with these
infectious agents, and because unlike naturally occurring outbreaks, these are initiated by people
who intend to cause harm. As such, the methods and nature of exposure are unpredictable and
outside normal disease transmission routes.
• Approach —The proposed work plan will ensure system wide improvements through
g
collaboration and coordination of state efforts with those of our key partners: local public health.
hospitals, emergency management services, and health care providers. An effective system
requires the rapid detection of illness by health care providers and labs, secure and dependable
communication with public health disease investigators, and response plans to deliver necessary
medicine or vaccines quickly. The system must provide clear health information to the public
and technical assistance to the many different responders. Those responders all need appropriate
and continuous training and education in the diseases of concern, and their individual roles in the
overall system plan. Key partners in many areas, including local health, physicians, nurses,
hospitals, emergency medical personnel, have been very involved in the work plan and are
included in the proposed capacity development efforts.
The Work Plan - The work plan lays out the framework for a public health system that
recognizes certain critical centralized capacities, such as the state public health lab and the
development and maintenance of a statewide information technology system. It increases the
local capacity to detect and investigate diseases and coordinate a local response. Regional plans
that link hospitals, local health and emergency responders do not currently exist and this work
plan will allow the development of such plans. Finally, the work plan will build capacity in DOH
to respond to a public health emergency, and to test and exercise the resultant response plans.
•
1
r ^
•
•
•
The work plan is organized into six major focus areas with a number of CDC required critical
capacities within each focus area:
•
• Area A: Preparedness Planning and Readiness Assessment
• Area B: Surveillance and Epidemiology Capacity
• Area C: Laboratory Capacity—Biological Agents
• Area E: Health Alert Network/Communications and Information Technology
• Area F: Communicating Health Risk and Health Information Dissemination
• Area G: Education and Training
Timeframe and Funding—The timeframe covered in this work plan is from May 15, 2002 to
Aug 30, 2003. This effort is primarily a needs assessment and planning phase. It is anticipated
that there will be additional funding in future years to address needs that cannot be met during
this funding cycle.
Budget work sheets are provided following this narrative to summarize the distribution of funds
within the focus areas and between local, regional and state entities.
Preparedness Planning and Readiness Assessment—this area deals with the assessment of the
state's emergency preparedness and responsiveness to a bioterrorist event, major infectious
disease outbreak, or other public health emergency. The state work plan proposes action to
address each of the critical capacities:
• Leadership—the agency will identify one key state public health official who will provide the
strategic leadership for public health preparedness and planning. We will convene a state
advisory committee to assist and advise the agency on the development and implementation of
the work plan elements and ensure linkage of public health issues to other state efforts related to
emergency preparedness and terrorism response plans. We will collaborate with the University
of Washington in leadership development around the public health competencies associated with
planning and preparedness.
An oversight steering group composed of key state, local, and hospital representatives will
provide leadership and accountability. This group will meet regularly and monitor progress,
accomplishments, barriers, and needs to alter approach.
Assessment—The agency proposes a coordinated assessment of hospitals, local health, and
emergency management systems to determine existing capacities and identify gaps for
subsequent planning efforts at the state and local level. We will use existing information to help
conduct this assessment.
Included in the assessment work will be a review of the statutory and administrative codes under
which public health actions would be taken in response to a biological emergency.
A regional system will help coordinate local health jurisdictions in assessment and
implementation. This approach ensures that every local jurisdiction will create basic capacity,
while strengthening response systems by virtue of a regional plan. The regional framework will
2
include identification of a lead local health agency for each region, with that agency taking
responsibility for providing assistance and guidance to the other agencies in the region.
• Preparedness and Response Planning - This critical capacity addresses the ability y to exercise a
comprehensive emergency management plan. The agency will meet this capacity by describing
pre-event preparation, outlining the response to communicable disease emergencies, and
highlighting the uniqueness of a biological event.
The agency will define roles involved in managing mass casualty and fatality events so that our
comprehensive emergency plan is consistent with the state emergency management plan. A
senior public health official will be designated as lead coordinator.
Each local health jurisdiction will produce a written plan around the public health functions they
will perform during an emergency response. The local plans including county CEMP will be part
of a coordinated regional and state plan.
Federal Asset Coordination—This critical capacity addresses the agency's ability to coordinate
with federal programs, most particularly the National Pharmaceutical Stockpile. We will develop
plans for the receipt, storage, distribution and proper identification and training of individuals
that will handle these pharmaceuticals during a time of emergency.
National Pharmaceutical Stockpile—This critical capacity is intended to establish the ability to
manage the delivery and distribution of a large "push package." These "push packages," which
are part of the stockpile, contain medical supplies and pharmaceuticals that would be delivered to
• the state within 12 hours of a request by the governor. Preparation includes local planning,
training and exercises involving push package distribution plans.
Surveillance and Epidemiology Capacity—This section of the work plan deals with the
detection and response to disease outbreaks and consists of three critical capacities:
Rapidly detect a terrorist event or disease outbreak through an efficient, mandatory reportable
disease surveillance system—The work plan for this capacity is to increase available local and
state disease surveillance staff. These people will work with key health care providers in
identifying and reporting communicable diseases. DOH will develop and provide training on a
secure, confidential system for local health agencies and health care providers. This will provide
disease surveillance data through a Web-based system, known as Public Health Issues
Management System (PHIMS). This will assure that local health jurisdictions can receive urgent
disease reports from all parts of the state. We will pilot alternative disease surveillance strategies
in selected regions, such as monitoring 911 calls or Emergency Room visits. A standard protocol
will be developed and applied to regularly assess surveillance activities. Training will be
developed and provided to disease reporters and public health staff to increase awareness of the
importance of surveillance systems.
Comprehensive and exercised epidemiological response plan—In order to meet this critical
capacity, each region will designate an epidemiological response coordinator who will work with
local public health in their regions to develop local and regional response plans. These plans will
110 use secure information systems, will be linked to the broader public health and hospital
emergency response plans, and will be strengthened by mutual aid agreements, and training
plans. This effort will focus on routine training and exercise of developed plans.
3
Rapidly and effectively investigate and respond to a disease outbreak— We will develop
• standardized protocols for public health investigation and response. Public health investigation
and response will be routinely assessed to identify improvements. After-hours response plans
will be developed by all local health agencies to provide a rapid response to urgent public health
issues. Current communication modes will be expanded to ensure that urgent messages can be
delivered and received in an effective and timely manner. Communication tools, education, and
protocols will be developed and presented to public health and veterinary professionals to
improve animal disease surveillance.
Laboratory Capacity—This focus area addresses the clinical laboratory capacity of the state to
accurately and quickly identify a potentially infectious agent. It requires two critical capacities:
1) establishing rapid laboratory response capability with enhanced public health laboratory
security and infrastructure and 2) assuring adequate capacity by developing a coordinated system
of lab services in the state.
Rapid Service Response and Enhanced Infrastructure—This capacity will be met by increasing
the number of trained microbiologists at the state Public Health Laboratories and investing in
new technology. This will decrease the time it takes to identify potential pathogens using
advanced DNA analysis.
Establishing a secure electronic communication system will assist in transfer of information and
test results between laboratories, with our neighboring states, and with CDC. We will increase
our emphasis on safe handling of biological agents and specimens.
• We will establish plans with law enforcement agencies and hazardous material responders on
sample collection, transport and chain of custody. Security at the state public health labs,
including safe storage of equipment and samples or specimens sent to the lab, will be improved
to ensure the safety of our staff and the public.
The surge capacity issue will be addressed by enhancing two local public health laboratories
(Spokane Regional Health District and Public Health - Seattle and King County) so that they can
perform critical tests as needed, and test environmental samples as appropriate. We will establish
agreements with other advanced microbiology laboratories at the University of Washington,
Washington State University, and Madigan Hospital so that they can provide confirmatory
testing should the public health laboratory system become overwhelmed.
Assuring Adequate Laboratory Capacity—We will provide training and technical assistance to
enhance the ability of private and public sector laboratories statewide to perform initial screening
tests for microorganisms that may be associated with bioterrorism. We will establish an
evaluation process, including proficiency testing and practice drills, to monitor the capability of
laboratories around the state to correctly identify critical disease-causing microorganisms. The
enhanced electronic communication system described previously will increase the ability of
laboratories to share information. We will facilitate inter-lab agreements for mutual support and
backup.
Health Alert Network- This focus area addresses the need to move information and data
quickly and securely in order to detect or respond to a bioterrorism or other public health event.
It is composed of four critical capacities.
4
Communications and Secure Connections–During a public health emergency, it's crucial that
providers and state and local health agencies share information quickly and securely. This
capacity is intended to provide a secure system to exchange health information safely. We will
work with local health to assure that 90 percent of the state's population lives in a health
jurisdiction that is connected to this system. We will establish a secure Internet-based system for
providing public health emergency information to public health officials, hospitals, laboratories,
clinicians and local first responders. Authorized individuals will be listed in a directory that notes
their level of access to the system.
Emergency Communications–This capacity ensures that a variety of communication systems
are available during an emergency. We will assess current systems available to local responders;
identify the best methods within regions (including redundancy); distribute needed equipment;
establish necessary policies and agreements; and conduct systems tests. There will be a strong
focus on working with existing emergency management systems and operation centers.
Protection of Data and Information Systems–This capacity focuses on the security of the
information system. The work plan includes a review of state and local practices and policies on
information technology security. That review will provide direction for consistency in systems
and improving security. We will create a system of digital certificates to allow appropriate user
access to a secure, Web-based information system, develop a secure machine-to-machine data
transmission system. The system will be tested periodically to be sure it works.
Secure Electronic Exchange of Public Health Information–This capacity addresses the need to
• automatically transmit clinical data from laboratories and health care facilities to public health
agencies and disease investigators. We will assess existing capacity, find gaps and needs, and
provide equipment, software, training or policies to fill those gaps.
Once the capacity to exchange data is established, the data will be reviewed and analyzed by
trained epidemiological investigators at the local and state level. On-going efforts include trend
analysis (as data increases over time) and routine maintenance and quality control of the system.
Risk Communication and Health Information Dissemination–This focus area draws
attention to the capacity of the public health system to provide critical public health information
during an emergency. It includes ongoing outreach to the general public and special populations
on topics related to emergency preparation. Starting with an assessment of risk communication
capacity on the local and system levels, the plan uses a mix of regional and system-wide
resources to ensure public health system readiness.
Newly created system resources—both centrally and regionally located—will work with regional
public health emergency communications advisory committees that may be established as part of
regional workgroups created under the "Preparedness Planning and Readiness Assessment" of
this project. The majority of their efforts will focus on providing a coordinated system-wide
resource for risk communication training, building a comprehensive library of materials for staff
and the public, ensuring consistent public health messages, and supporting special community
outreach efforts.
SThe work plan contains an interim plan to address risk communication needs should something
occur before the existing capacity is improved. This interim plan calls for DOH to activate an
5
Emergency Communications Strategy to provide support to the public health system through the
DOH Communications Office. This emergency response plan includes activating an emergency
• call center, disseminating specific and general health information as necessary (to system
partners and public) based on the nature of the emergency, and responding to inquiries from the
media and general public.
Education and Training—This focus area deals with a delivery system for education and
training of public health officials, emergency responders, and health care providers. The plan
proposes multiple learning strategies for training public health officials. Generally, these can be
achieved with three factors:
• Human Resources—state and local training coordinators throughout the regions.
• Technology— build on existing community assets and enhance technology to offer other
training options, including video conferencing and Web-based learning.
• Barriers— identify and remove or reduce access barriers to learning opportunities, including
subsidies to assist with travel and time away from work during training.
Integration with Hospital Planning—The work plan for the CDC bioterrorism preparedness
funding application is coordinated with the proposal to Health Resources and Services
Administration for hospital planning. The Health Resources and Services Administration funding
application is intended to upgrade the preparedness of hospitals in Washington, and their
partners, to respond to bioterrorism. The primary focus of is assessment and planning.
Ultimately, Washington will have a hospital system capable of responding to acts of
bioterrorism, other outbreaks of infectious disease, public health threats and emergencies. It is
important to coordinate these two applications, and examples of this coordination include:
• Needs Assessment—careful attention is made to coordinate the needs assessments required in
both proposals. The existing emergency medical services regional councils will assist with
linking hospital needs with those of first responders and including this information into local and
regional preparedness planning related to developing their emergency response plans.
Regional Preparedness Plans—the hospital plans to develop regional preparedness plans will
include elements related to antibiotic and vaccine distribution and workforce development. The
activities in the CDC work plan for National Pharmaceutical Stockpile planning, communication
systems and training/education efforts clearly link to these proposed activities. It is proposed that
exercises and drills be coordinated to test hospital and public health plans jointly.
Establish Critical Benchmarks—The HRSA proposal contains several benchmarks that lead to
coordination. In particular is the creation of the Hospital Bioterrorism Planning Committee,
which will be linked to the larger DOH Bioterrorism Response Advisory Committee. A smaller
project-focused Bioterrorism Response Steering Committee is planned under the leadership
section of Focus Area A, and a hospital representative will be a member of that committee.
Infrastructure—This element of the Health Resources and Services Administration proposal
deals with the long-term maintenance of hospital plans within the state. The integration of the
Health Resources and Services Administration plans with CDC and Metropolitan Medical
Response System plans is noted. There is opportunity for coordination in the review of legal
• authorities and regulatory support structure around isolation procedures.
6
Data Collection— One critical capacity in the CDC proposal is the development of a secure
information system through which we can send and receive clinical data and important public
• health information. That information system will serve to assist hospitals with the transfer of
critical data (bed counts and availability) as well as provide reports on the progress made in
filling the gaps identified in the needs assessments.
Integration with Metropolitan Medical Response System - Three cities in Washington
(Seattle, Tacoma and Spokane) are designated planning areas under the Metropolitan Medical
Response System plan guidance. The plan for Seattle is completed. Tacoma and Spokane are in
the process of developing plans. When these plans are available, they will be reviewed along
with the Portland, Oregon plan. They will be integrated into the regional and statewide planning
efforts.
Integration with Tribes and Federal Facilities — There are 29 Federally recognized Tribes in
Washington. However, few have significant health care facilities that might serve as an asset
during a biological event or infectious disease outbreak. Communications have been initiated
with Tribal health care organizations to seek representation on the Bioterrorism Response
Advisory Committee, but the primary communication with Tribal communities is the need to be
engaged at the local and regional planning level, through integration in the local emergency
response plans.
There are several major federal facilities in Washington, including VA Hospital and several
military health care facilities. We will have representatives from these facilities on the state
advisory committee.
• Conclusion — This federal funding applicationrocess is the beginning of long-term
p g g a g term
responsibility that will continue to evolve. Much of the work in the application is built on the
foundation DOH established in more than two years of previous bioterrorism response planning.
Our broad, system-based approach to the previous work on bioterrorism and public health
emergency response has been extended to this application. People from throughout DOH have
been joined by local health, hospitals, providers and emergency management, who have all
played a key role in this work plan development. We have charted a challenging course and
included partners in this work. The benefits include having the entire public health system
involved from the start, so we can work together to be better prepared today than we were
yesterday, and better prepared tomorrow than we are today.
•
7
•
Board of Health
New Business
Agenda Item # V., 3
•
Legislative Wrap-Up
April 18, 2002
•
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ESSB 6588 Page 1 of 1
April 4, 2002
• To the Honorable President and Members,
The Senate of the State of Washington
Ladies and Gentlemen:
I am returning herewith, without my approval, Engrossed Substitute Senate Bill No. 6588 entitled:
"AN ACT Relating to food service rules;"
Substitute Senate Bill No. 6588 would have provided sole rulemaking authority to the State Board of
Health for food service rules, and it would have made the state Department of Health the exclusive
authority to interpret the rules.
I support the development of a statewide food code that will protect all the citizens of the state, as well
as provide more uniform standards for restaurants and other food handlers. However, such an effort
must leave enough flexibility for local health jurisdictions to make adjustments to accommodate their
unique circumstances. It is not necessary to diminish the existing powers or duties of local health
authorities in order to gain a greater level of uniformity across our state.
It is my understanding that the State Board of Health is already working to revise our state's food code. I
encourage local health authorities to work with the regulated community and the state to make sure the
new rules provide uniformity wherever practical, and are comprehensive enough to address unique local
circumstances. I would like to see a state code that allows for narrow or limited deviations, and can be
readily adopted by local jurisdictions.
While this bill attempted to allow a local health board to adopt temporary deviations from the state rules,
to respond to emergencies that "threatens the public health or safety," it is unclear what constitutes an
emergency for this purpose. This bill is too restrictive of local health authorities.
For these reasons, I have vetoed Engrossed Substitute Senate Bill No. 6588 in its entirety.
Respectfully submitted,
Gary Locke
Governor
•
http://www.governor.wa.gov/02leg/veto/6588.htm 4/9/02
•
Board of Health
Media Report
1
April 18, 2002
1
• Jefferson County Health and Human Services
MARCH — APRIL 2002
NEWS ARTICLES
1. "County, environmentalists settle", P.T. LEADER, March 13, 2002.
2. "Panel looks past need for doctors", Peninsula Daily News, March 15, 2002.
3. "Saddler: Elected officials got me fired", P.T. LEADER, March 20, 2002
4. "Read-aloud project still open", P.T. LEADER, March 20, 2002.
5. "Hadlock auto repair shop is EnviroStars winner", P.T. LEADER, March 20, 2002
6. "Jefferson residents in good health" (2 pages), Peninsula Daily News, March 24, 2002
7. "County's health survey: Most of us in good shape", P.T. LEADER, March 27, 2002
8. "Deputies await test results in meth bust", Peninsula Daily News, March 27, 2002
• 9. "PA syringe-trade locale moving to new location; Jefferson program to continue at
health department",Peninsula Daily News, April 4, 2002.
10. "'Critical access' may help hospital", Peninsula Daily News, April 4, 2002.
11. "State targets water use: New meter rules", Peninsula Daily News, April 5, 2002
12. "Panel formed to keep water fresh in wells", Peninsula Daily News, April 9, 2002
13. "Hospitals ready for new state contraception law", Peninsula Daily News, April 9, 2002.
•
I
•
County envirsettle
Jefferson County has agreed government officials engaged turbed by new development. It public health, public safety and
to address several environmental in constructive dialogue can will develop a process for classi- the property damage resulting
issues in the coming year under produce creative solutions that fying and protecting state prior- from development in areas prone
a negotiated settlement with the protect the environment and ity and locally important species to flooding.hazards."
Washington Environmental address the concerns of local and'their habitat, using:a land- Gorsline said the environmen
Council (WEC). government."
The council hada Baled nu- scape-based approach where tal council's dispute with
PP County Civil Deputy Pros- possible. Jfferson Cunty focused on
merous provisions of the ecuting Attorney David Alvarez Beginning with Chimacum meth ds to achieve the county's
county's Unified Development agreed:"I think it's a good corn- Creek, the county will initiate a stated goals to protect and en-
Code pertaining to floodplauts, promise.It,c qws,us,to;pfoceed -collaborativq,stakeholder effort hance wetlands,fish and wildlife
wildlife and wetlands.
with what we wanted to do any- to develop a systematic, volun- habitat.
The agreement, finalized way.It stops the legal process so tart'watershed-based program to "We have a lot of work to do
March 5,settles a lawsuit which we can focus on science and data address the impacts of agricul- to implement this agreement,"
had been brought by WEC alleg- gathering." ture on salmon habitat. If the said Dave Christensen, county
ing that the county had failed to The agreement calls for voluntary approach is not imple- natural resources division man-
follow provisions of the law Jefferson County to initiate a mented within two years, the ager. "We're looking forward to
which require the county to pro- project to identify and map flood county will adopt new regula- working with WEC to put this on
tect salmon habitat and other hazard areas and river meander tions to address the impacts of the ground. We actually began
critical areas from the harmful patterns of the major eastern agriculture on fish and wildlife down this pathway last year,when
pacts of development and county rivers, followed by an habitat.
er activities. update of its regulations to bet- wwe obtained state funding to iden-
ning salmon
`This agreement is a real win ter protect fish and wildlife in the all residents of the county,"said habitat inl benefit tify thesteasterin Jefferson
for both the environment and the floodplain.The county will also County Administrator Charles County. Our next projects will
county," said Jerry Gorsline, follow a policy developed by the Saddler. "Not only will it im- include wildlife habitat mapping
WEC policy associate."It shows state Department of Ecology for prove fish and wildlife habitat, and improving knowledge of flood
that environmentalists and local replacing wetlands that are dis- but it also will reduce risks to hazard areas."
IP, r L49 .
3 -(3 -02
, ,
Panel looks
III
past need
for doctors
Study finds "We realized there was a
funding key deep and widespread ,
interest in health care.
to health care Problems surfaced in a
variety of ways,and we
BY JIM MANDERS 'decided�to take the issues '
DAILY News in our hands with the main
i••rere are r.-, : .,..,s focus on access."
enough doctors e ' JUDITH MORRIS
to serve the 'r!..-:-. Healthy Communities
Port Angeles
and Sequim .-°`w- :_�
areas, but peo- ,./ There is an incorrect percep-
ple older than tion that most people in Sequim
H5 who use are rich.
Jled icare or As a result of the federal des-
Medicaid often ;' ignation, the area qualifies for
don't have Morris rural health clinic status which
access to physi- allows clinics that meet certain
clans because criteria to receive higher reim-
of the low reimbursement rates bursement for Medicare and
paid through government Medicaid patients.
insurance programs.
That's one of the conclusions Children's Clinic
reached by a committee study-
ing access issues as part of Peninsula Children's Clinic
United Way's Healthy Commu- in Port Angeles is one of the
nities Initiative. clinics to receive the designs-
• Judith Morris, director of tion,according to Morris.
the Healthy Communities pro- "It's a short-term,quick fix,"
gram, said 22 percent of the Morris said, noting that boost-
people in Port Angeles and ing reimbursement rates is the
Sequim areas are covered by only long-term solution,
Medicare or Medicaid insur- She said higher reimburse-
once programs. ment rates will have an effect
Those government-funded on taxpayers who foot the bills
insurance programs reimburse for the programs.
about 50 cents on each billed Helping people with access
dollar,causing many doctors to to physicians is only part of the
limit the number of Medicare committee's focus,Morris said.
and Medicaid patients they can "We want to make sure
accept. there's no'wrong door'for peo-
Morris, who has led the ple to walk through," Morris
access program since its incep- said, explaining that people
lion two years ago, said the should be able to get pointed in
committee includes health care the right direction or obtain
professionals, social service accurate information on finding
providers and business owners. a physician.
It started meeting after Rep. Morris said the business
Norm Dicks, D-Bremerton, community is involved with the
held a health care forum on the committee to the extent that
Olympic Peninsula to obtain companies thinking about relo-
background on issues facing cating take a hard look at edu-
Clallum County residents. cation and health care systems.
Health care interest "A strong health care system
keeps money in the commu-
"We realized there was a nity,"Morris said.
deep and widespread interest in
'leak h care," Morris said. Not serious enough
Problems surfaced in a variety
of ways,and we decided to take While physician access is a
the issues in our hands with the problem in central Clallam
main focus on access." County it isn't serious enough
The main issue was barriers to qualify the area for a federal
to health-care access because of medical clinic,Morris said.
the low reimbursement rate. "It's a very complex and
Morris said some committee comprehensive process," Mor-
e
members focused their energy ris said. "You have to be med-
r efforts to increase reim- ically undersized and we're not
bursement rates but have been sure we're going to qualify"
frustrated because the policy- Morris thinks the commit-
makers are based in Olympia tee's strength is in the
and Washington,D.C. approach being taken to solve
One of the accomplishments the wide range of access issues. f7 �� _D Z
of the committee is to secure a "We're not unique in the �)—
federal government designation problems we face be we are
of Port Angeles and Sequim as unique in how we approach
!ow income areas, Morris said. them,"Morris said.
3
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t a .. a E
illP J1
C � o TU V
N U
v u 3 2 v v0
•
Read-
aloud
project
still open
A free study,funded by the
University of Washington and
aimed at delivering informa-
tion to parents about building
reading readiness in young
children,still has openings for
interested parents.
Colleen Heubner,assistant
professor at UW, said the
"Hear and Say Reading for
Toddlers"project has enrolled
about 75 Jefferson County
parents but still has room for
many more. The project,
sponsored jointly by UW
Sandand Jefferson County Health
Human Services De-
partment, looks at different
ways of transmitting infor-
mation about the signifi-
cance of reading aloud to
parents of 2-and 3-year-old
children. Parents receive an
instructional video and two
children's books as a thank-
you for participating.
The program is open to all
Jefferson County residents
who live with young children;
grandparents and foster par-
ents are also encouraged to
participate.
Heubner and other read-
ing specialists have as-
sembled research that shows
that reading aloud to tod-
dlers builds reading readi-
ness in preschoolers and
prepares them for school.
To learn more,or to enroll
in the project,call 379-4471.
3 -w
` Ta-oer2.
' S
Jiadlock auto repair shop
•
is EnviroStars winner
By Philip L.Watness ;itAL, ( l, " " throw anything away,"Filli said.
Leader Staff Writer [ - e "It's the right thing to do in the
i ; I �p't t , \_ '� 1. long run. I hope to maybe help
& ' , 1 ,'� , `' other businessesget exposed to
Reto Filli has an abiding sense �jb ate , ,t P
of stewardship from seeing as a j 3c ¢` a the idea that a business can still
youth the waterways of his na- f} 1"' + • -* be profitable [despite recycling]
and also do the right thin "
tive Switzerland polluted beyond ,' # ./.11 -./.,s.
ar. s.i ,1g
usefulness. \rg �� a' Molly Pearson, county envi-
So when Filli and his wife, 't °'' ronmental health educator, said
F s+;� a r
the EnviroStars Program will be
Jana, planned the new Circle & y ,, i ---`._„1,,,,,,. ; a.�4 _ , g
Square Automotive Repair shop �_ K offered to other small businesses
,,:, . ,,,ate,,: t , ,
in Port Hadlock, they went to vq� ,� ts-7 .,� handling environmentally harm
extraordinary lengths to ensure 1 r. 'm . ful products.Those could include
anything and everything that . t -' �/ _ , i,,,,,,..., E. print shops, dry-cleaning facili-
could be recycled would be re- . ` ••••• . ri ties and even dental offices.
cycled, right down to the metal .. f "The award goes to small gen-
and oil inside oil filters. ��r, .� ; '�;-�, erators which sometimes use ex-
That environmental steward- � � tremely hazardous chemicals,"
i led to the Governor's Award 4'". f�
p Molly Pearson said.
Wat recognized "green" busi- V. •`-• 1 ;:,.,.1...,&]„...,..,,,,,...„,
M 'li', '..'.:4Businesses in Jefferson
nesses like the Fillis'. wag- .:' `°`' • ` P• '' ••,'"' County that participate in the
It comes as no surprise,then, -:i ' t,; ,•'.= .. .-; Y' program will benefit from join-
that Circle & Square will be the Q .,.. ing such large counties as King.
inaugural business for the ryes i Pierce and Snohomish because
Reto and Jana Filli,owners of Circle&Square automotive repair shop theypayfor the lion's share of
EnviroStars Program in Jefferson in Port Hadlock, stand near a machine that pumps used antifreeze
County.The automotive shop re- the advertising costs which ben
out of automobile radiators so it can be recycled. Submitted photo
ceives its five-star rating as the efit all six counties. Whatcom
program is kicked off at noon helping educate other companies. ing much of it to heat the build- and Kitsap counties are the other
Thursday, March 21, by the That's another reason why ing.Mechanics use a machine to two participants.
Jefferson County Environmental Circle & Square was an ideal pump radiators dry in order to "The whole idea is to help
Health Department. business to launch the local pro- make sure not a drop of anti- businesses reduce hazardous
"What they've done is shown gram, Pearson said. freeze meanders away.The same waste, tell the public who's do-
a facility-wide commitment to "Five-star winners need to machine pumps new fluid into ing a good job and encourage
the environment from the get- show they're leaders in their the radiators.Another method of consumers to shop at those busi-
go,"said Pat Pearson of the Puget community," she said. "They keeping oil and grit from enter- nesses,"Pat Pearson said.
Soundkeeper Alliance. "They must educate customers or work ing the environment is a The local program is funded
w
really looked at the environment with local colleges to help edu- washdon bay in which the waste- with approximately$5,000 avail-
when they were building this cate others.They often host opwater is collected and filtered. able through two matching grants
building.Other auto repair shops houses tO share what they den o." .` "The mentality I grew up with from the Washington State De-
do the same things, but they Jefferson County Environ- makes it very hard for me to partment of Ecology.
probably didn't have to go to this mental Health specialist Melinda
length." Bower said the Fillis' success
Pearson coordinates the could help convince others to do
EnviroStars Program in the six similar environmentally friendly
articipating counties. She said things.
program sets the bar pretty Filli explained that his auto-
gh, requiring businesses to motive shop recycles brake fluid,
go beyond recycling waste to transmission fluid and oil,burn- 3 _ o' i ,O a—
SO
•
Jefferson
residents in
good
health
plans and policies for health care.
Survey vey shows The survey asked randomly
selected residents a series of 170
above-average questions during 25-minute tele-
phone interviews conducted from
habits, lifespan
April through December.
"In terms of adult health, the
news is really good," said epidemiol-
BY STUART ELLIOTT ogist Dr. Christine Hale, a Seattle-
PENINSULA DAILY NEWS based consultant who analyzed the
numbers and presented her findings
Jefferson County residents smoke to the county Board of Health.
• less, exercise more and live longer
than other adults in Washington Better than state average
state, a yearlong survey of county "Jefferson County looks better.
residents shows. than Washington state, and Wash-
Preliminary results of a survey of 600 residents conducted last year in on state looks really good" com-
show the county faring well in terms pared to the rest of the country, she
of a number of key health indicators said.
from frequency of routine physical Continuing a trend that has held
exams to a lower level of binge drink- steady for at least the past 20 years,
life expectancy in Jefferson County
ing. was higher than life expectancy
The positive results were par- statewide.
tially offset by findings that those in For 1995 through 1999, life
lower income groups — including expectancy ithroughrson county was
family households in Jefferson p cy
County and those in the 18 to 34 age -79 years,compared with 77 years for
group — had less access to health the state, Hale'said.
care and were more likely to smoke Despite apparent problems to
and drink heavily. accessing health care, a greater per-
The $25,000 Behavioral Risk Fac- centage of local residents reported
tor Surveillance System survey was, they had a *regular health care
commissioned by Jefferson County provider and a check-up during the
.v).' last year.
and the city of Port Townsend in an
''`effort to get hard data to help shape TURN TO HEALTH/A6
• 3 -a,kf-e c)---
PENINSULA DAILY NEWS
Health: Jefferson survey
• CONTINUED FROM Al While 17 percent of all
Seventy-five percent of Jef- Drinking alcohol is a not' adults in Jefferson County are
ferson county adults had a rou-
mauve activity in efferson heavy drinkers, 28 percent of
tine physical in the last 12 County. It's done in the adults in family households fall
months,compared to the state in this category.
p European pattern here—
rate of 68 percent. it's moderate, it's low and More smoking
Approximately 90 percent
of people in Jefferson County it's steady." Adults in family households
have health insurance. DR.CHRISTINE HALE also smoked more — 24 per-
And 85 percent of county analyst cent smoke compared to 16
residents reported they have a percent of all county adults.
I doctor or health care provider anthrax,is smoke cigarettes." Specific on the 18 to 34 age
where they could go to get group will be released in the
treatment. Exercise encouraging next month along with other
That's slightly higher than survey results.
the state average of 83 percent. Results concerning exercise Hale said she expects simi-
"Unfortunately, the survey were also encouraging, Hale lar findings to the data
didn't ask 'how far do you released on adults in family
"You might have access,but County residents reported households.
Mac-
it might be two hours away," themselves as physically inac- "These are the two biggest
added Jean Baldwin,Jefferson tive, meaning they did not risk groups," she said. "They
County Community Health exercise three times a week for are the two groups where the
director. 20 minutes at a time or engage health reported is different
in physically demanding work. than the rest of the popula-
Family household adults That number was less than tion."
half the statewide average of Board of Health members
The generally rosy health 27 percent. — including hospital commis-
care picture was also slightly The report also found Jef- sioners, Port Townsend City
marred when one looked at ferson County residents drink Council members and Jeffer-
family households, defined as more frequently than others in son County commissioners —
households with children the state,but not to excess. who listened to Hate's presen-
said.under 18 years of age, Hale Jefferson County residents tation Thursday said the sur-
are three times more likely to vey will be useful in making
Only 65 percent of adults in drink 20 or more days a future policy decisions.
family households had a rou- month. "Since I've been on the
• tine checkup during the last Twenty-four percent of board, we've heard anecdotal,
year,compared to 74 percent of county residents reported and clinical information, but
all adults in Jefferson County. drinking on 20 or more days of this is the first time we've had
Hale said that could be a 30 day
attributed to lower income lev- period, compared to data we can depend on,"board
els, though the study wasn't only 8 percent statewide. member Sheila Westerman
successful in obtaining a reli- But"binge"drinking is not said.
able measure of income. prevalent—only 17 percent of
Adults in Jefferson County Jefferson County adults drank Commingling the data
• in familyhouseholds were also more than five drinks at one
time duringthepast 30 days, Board member and City
less likely to go to a dentist Y ' Council member Geoff Masci
because of the cost,Hale said. compared to 23 percent
statewide, said the data could be commin-
"The highest rates of Hale said alcohol consume- gled with already collected
poverty nationwide come in tion is strongly tied to educe-
households" information.
households" where the chit- "This was commissioned to
dren are under 18, Hale said. tion, pointing out that educa-
tion levels in Jefferson County help us discover where we
County residents were also should
are extremely high. put our money or not
more likely to have higher
blood pressure than the rest of The more education, the put our money,"Masci said. "I
the state — 29 more likely one will drink, think this was a good invest-
percent Hale said. ment."
reported having high blood Over the next month,board
- pressure here,compared to 22 "Drinking alcohol is a nor-
percent statewide. mative activity in Jefferson subcommittees will likely be
"A diagnosis of higher blood County,"she said."It's done in formed to analyze data in
pressure becomes more corn- the European pattern here — depth, focusing on topics like
mon as a population ages," it's moderate, it's low and it's substance abuse or needs of
Hale said. "We have twice as• steady." low-income families or senior
many people over 65"than the "Now,I understand why the citizens.
state average,she said. cheap French wine goes out of The telephone survey, con-
Good news also came in Jef- the Food Co•Op so fast," ducted by Seattle-based
ferson County residents' quipped Baldwin. Gilmore Research, was based
responses concerning smoking Binge drinking, as well as on questions developed by the
and exercise. smoking, were higher for U.S. Center for Disease Con-
Only 16 percent of adults adults in family households in trol and Prevention in the mid-
smoked cigarettes in 2001,sig- Jefferson County,Hale said. 1980s.
nificantly lower than the
S . statewide rate of 21 percent.
I Hale referred a national
benchmark that aims to cut
• smokers to 13 percent of the _
population by 2010.
"We're just about there,"
I she said. "The single worst
thing you can do to your
health, short of inhaling
•
• March 27, 2002 7
'TLeader.com * Visitor Info Website:Olympic-Peninsula.com Vol.113 No.12
• County's health survey:
Most ofusinshapegood
By Janet Huck "Jefferson County adults enjoy better access to health care providers,knowl-
Leader Staff writer health than the residents of.Washington edge of blood pressure,physical activ-
state,which has one of the best health rates ity, oral health and family violence.
The news is good,really good,said in the United States,"said Hale. Answering the telephone questionnaire
University of Washington epidemiolo- The epidemiologist was commis- took about 20 minutes.
gist Christian Hale, who analyzed the sioned by the Jefferson County Depart- The 292 male and 311 female re-
data from an extensive health survey of ment of Health and Human Resources spondents ranged in age from 18 to
Jefferson County adults. to analyze the data from the Behavioral 94,with an average age of 52.5.It was
Overall, the adults of Jefferson Risk Factor Surveillance System,agues- a highly educated group, with 229
County exercise regularly,consume al- tionnaire developed by the Centers of • having completed four or more years
cohol responsibly, get regular medical Disease Control.From April 1 to Dec. of college. Sixty-eight percent were
checkups,smoke tobacco in small num- 31, 2001, 603 randomly selected resi- married. More than 70 percent re-
bers, and live nearly a maximum pos- dents in Jefferson County were asked ported they had lived here five years
sible life expectancy. 170 questions about their health status, See SURVEY,Page A 10
Survey: Above state average
Continued from Page A 1 consumption may model behav-
ago. The most recent arrivals Comparison between Jefferson County for for younger people.
tended to have more education.
Although some people didn't adults as a whole and parents
g p p Abuse too
•give usable information about children younger than 18 There was one other outstanding
income,22 percent of those who A:All Jefferson County adults anomaly in the study.County resi-
did reported annual income of B:Adults with children below age 18 dents report higher rates of abuse
less than$25,000 and 33 percent - in childhood than the state and
of more than$50,000. Had a recent medical routine checkup national averages, and this abuse
A:74% B:65% affects their functioning as adults.
Big contrast Overall,25 percent—one in four
However, the health news Could not afford a dentist —of the respondents reported at
wasn't nearly as glowing for A:42% B:68% least one abusive experience in
adults ages 18 to 34 with at least childhood,a level above the state
one child living at home. The Regularly smoked cigarettes rate of 20 percent.The definition
survey indicates they have higher A: 16% B:24% of abuse included having been
rates of alcohol consumption and punched,kicked.choked or receiv-
tobacco use, and experience Consumed five or more alcoholic drinks daily ing a more serious physical pun-
some type of abuse.Hale is look- A:17% B:28% ishment from a parent or guardian.
ing at the statistics for all adults Those who reported child-
in this age range, who she said hood histones of abuse revealed
Experienced physical abuse in childhood
look different from other A:9% B: 15% significantly more days of poor
Jefferson County adults and dif- physical and mental health in the
ferent from their peers statewide. Source: Behavioral Risk Factor Surveillance System, previous 30 days than people
"We have identified two Jefferson County Board of Health without abusive life histories.
groups whose health is radically "You are looking at post-trau-
different,"said Hale."Something matic syndrome with impaired
different is going on in families twice the average use in Jefferson terns. About 68 percent con- relationships and dysfunctional
with kids than with the nice,rosy County. sumed at least one alcoholic families,"said Hale,who is con-
picture of adult health in the rest Of these respondents,27 per- drink in the last 30 days,signify- cerned that the abused adults
of the county?The contrast is so cent reported being overweight cantly higher than the state rate could repeat family patterns in
sharp." and also admitted to heavy alco- of 61 percent. Though county their own homes.
Hale didn't have an immediate hol use within the last 30 days— .residents reported drinking at a Hale and other health officials
explanation of the contrast except 60 percent above the average use steady rate,they drank a moder- hope this data will help policy
to say that the nation's highest in county adults. And among ately low amount.0
makers shape plans and policies
poverty rates are in households those who were overweight, 18 "It's done in a European pat- in Jefferson County.
with children under 18. percent were physically inactive, tern here—it's moderate,it's low "Since I've been on the board
Some of the younger adults in almost 40 percent above the and it's steady,"Hale said."They [of health], we've heard anec-
Jefferson County had multiple county's average inactivity level drank about one to two drinks a dotal and clinical information.
risk factors. Among those who among adults. day,which is exactly at the level but this is the first time we had
currently smoke, 34 percent re- The drinking patterns of that is protective of health" data we can depend on." said
ported heavy alcohol consump- Jefferson County adults as a Yet Hale expressed concern Sheila Westerman, Jefferson
tion within the previous 30 days, whole differ from statewide pat- that even responsible alcoholic County Board of Health chair.
Deputies awaittest
results in meth bust
• BY STUART ELLIOTT acting on a tip.
PENINSULA DAILY NEWS Jefferson County Department of
QUILCENE — Jefferson County Environmental Health workers
Sheriffs Office investigators are posted the Quilcene site Friday to
hopeful an analysis of fingerprints keep people away from potentially
hazardous materials there, Environ-
obtained at an outdoor methamphet
amine lab will lead to a suspect and mental Health Director Larry Fay
an arrest. said.
Fingerprints have been sent to the The owners of the timberlands
Washington State Patrol crime lab in will be required to clean up the site,
Olympia, Undersheriff Ken Sukert Fay said.
said. Evidence collected indicates those
"Although no arrests have been who used the lab were using the
made, we are hopeful fingerprint evi- anhydrous ammonia/lithium metal
dence recovered at the scene will aid process, or "Nazi" method, of manu-
with the identification" of a suspect, facturing methamphetamine,investi-
Sukert said Tuesday. gators said.
The analysis of the fingerprints Sukert said the lab was "moder-
could take three weeks to complete. ate" in size and may have had the
The fingerprints were obtained Potential to produce as much as a half
from a methamphetamine lab found Pound of methamphetamine, based
on timberlands in the East Quilcene on chemicals found at the site.
Road area Thursday by detectives TURN TO METH/A2
• Meth:
•
Quilcene
CONTINUED FROM Al wife, Rosanne, 39,are charged
Seized items include a gas- with manufacture of a con
powered generator, propane trolled substance after police
cylinders containing ammo- allegedly discovered a
nia, fans, coffee filters, a methamphetamine lab while
propane heating mantle, responding to a domestic vio-
muratic acid, solvents,lithium lence complaint.
battery cases, and other items The Makis are scheduled to
consistently found at metham- be tried May 13 in Jefferson
phetamine labs, Sukert said. County Superior Court.
Lead investigator Det.Dave Sukert said only about 10
Miller said the lab may have methamphetamine labs have
been in the woods near the been seized in Jefferson
intersection of McDonald and County in the last decade.
Gustavesen roads for one or While methamphetamine
two weeks. lab seizures in Jefferson
The lab, the second found County have been few and far
in the Quilcene area in the last between, Sukert said he is
three months, was inactive at aware of a trend of labs mov-
the time it was seized by law ing to more rural areas from
enforcement officials. Pierce and King counties as
The lab was much smaller law enforcement agents seize
than the "superlab" between sites there.
Port Angeles and Joyce seized The largest methampheta
by law enforcement officials in
January. mine lab discovered in Jeffer-
That lab produced as much son County was found in the
III as 200 pounds of methamphet Port Hadlock area in 1990,
amine in three months. Sukert said.
Last week's seizure follows It contained $20,000 worth
the discovery of a metham- of lab equipment and was
phetamine lab on the Coyle capable of producing up to 250
Peninsula in December. pounds of methamphetamine,
3-,):1--o,)
Phillip Maki Jr., 40, and his Sukert said.
• PA syringe-trade locale
moving to new location
Jefferson program p.m. Thursdays, according to public hearing before the pro-
health educator Kelly Ragan. gram started, she said.
to continue at If people need to make an The idea that people use
exchange at a different time, drugs is often hard for the gen-
health department they can do so by calling 360- eral public to understand, but
BY JIM MANDERS 385-9446. she said the exchange program
PENINSULA DAILY NEWS More than 2,500 syringes is important.
have been exchanged in 127
transactions involving 29 `Shoot safely'
There will be no syringe
exchange this evening in Port clients in Jefferson County
since the program started in "If people are going to shoot
Angeles but the program will
September 2000., drugs they need to shoot
open in a new location next
The number of syringe safely," Ragan said. "It might
week, according to Clallam
exchanges in Clallam County be hard for people to hear, but
County Health Department
officials. was not immediately available. it's about public health."
The address of the new loca- a Peninsula Daily News Encouraging safe use of
tion is available by calling 360- story published March 31, drugs goes beyond replacing
417-2412. 2001, reported 550 transac- used syringes.
tions involving 30 clients dur- Both health departments
The Port Angeles exchange
is open from 6 p.m. to 8 p.m. ing the first six months of the provide sterile equipment such
Tuesdays. program. as, bleach, towels, cotton and
The only syringe exchange "We do a one-for-one ties, in an effort to keep dis-
•
location in Clallam County is exchange, whether it's one or eases from spreading.
in Port Angeles. 100," Ragan said. Prophylactics are also pro-
Health departments in Clal- The syringe exchange isn't vided to help prevent sexually
held at the Clallam County transmitted diseases.
lam and Jefferson countn Courthouse, 223 E. Fourth St.,
sponsor the program, know
as Peninsula Syringe Port Angeles, because the
Sheriff's Department is in the
Exchange, which provides
same building with the health
clean equipment for people
who inject drugs into their department, unlike in Jeffer-
bloodstreams. son County.
People using the program in Opposed to exchange
Jefferson County can go to the
health department at 615 One person spoke out
Sheridan St. between 10 a.m. against the exchange program
and noon Mondays and 3-4:30 during a Jefferson County
•
/D
Critical access' ma hel hos itaI
Y p p
Jefferson officials weigh •options in Court said the hospital will "These are hospitals that are
have to look at how often occu- not focusing on acute care,"
atmosphere of declining revenues pancy rates spike during the Court said. "They are stabiliz-
year as part of the analysis in ing and enhancing outpatient
BY JENNIFER JACKSON Small hospitals are unable to deciding to apply for the pro- services."
PENINSULA DAILY NEWS survive financially because they gram•
lack volume and lack economies The hospital can apply for a Dirksen said in-patient
PORT TOWNSEND — Jef- of scale, Court said. grant to fund the financial activity has dropped with the
ferson General Hospital offi- state
"This could provide a safe analysis. advance in health care.
cials met Wednesday to hear harbor for ruralhospitalswho "We've seen our core activi-
about a program that could would be thrown into financial Critical designations ties go down," he said, noting
serve as a life raft for rural hos chaos by draconian cuts in core activities include surgery,
pitals sinking in what health Eighteen rural hospitals in
Medicare," Court said. obstetrics and treatingpneu-
administrators call "the perfect Washington state have been p eu-
storm." certified with critical access sta moria and diseases.
Medicare cut protection
The metaphor describes the tus since the program started. To be eligible for the pro
precarious position of small Rural hospitals are protected Of those, 50 percent had aver- gram, the hospital will have to
hospitals buffeted by rising from cuts in Medicare reim- age daily census of eight or develop outside oversight of its
insurance and other costs while bursements, but that protec- fewer patients, and 25 percent credentials and quality assur-
facing increased cuts in tion will be withdrawn in July had three or less, Court said. ance programs.
Medicare and Medicaid reim- of 2003, Court said. Nine more, including Forks
bursements. "We will lose $500,000 to $1 Community Hospital and Jef-
Independent primary care million if we are no longer pro- ferson General, are considering
is no longer sustainable in our tected," Dirksen said. "We're the move.
community," hospital Adminis- talking significant dollars." "You are what I would call
trator Vic Dirksen said. "We For a hospital to qualify as a folks on the edge," Court said.
have to look at options for sus- critical access care center, it "It's important to go through
must have no more than 15 the planning process and askOne option is acceptance in acute care patients at a time `does this fit us now' and will
,nabily"
e Critical Access Hospital and a limit of 25 beds. this fit us in the future?"'
program, said Bev Court of the Jefferson General Hospital Court said hospitals that
state Department of Health is licensed for 43 beds, but has convert to critical access status
and Welfare. only 37 beds available.The hos- realized financial benefits of
Court outlined the federal pital averages between 10 and between $200,000 and
program implemented in 1997 12 in-patients daily. $600,000.
for hospital officials Wednesday.
The critical access program
provides rural hospitals reim-
bursement of services for
Medicare and Medicaid patients
on the basis of cost instead of a
fee schedule.
•
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•
Panel
to keewater
fresh in
wells
First meeting preventing groundwater degrada-
tion under the state Growth Man-
' agement Act.
on salt problem The citizens group will hold the
first of four meetings at 10 a.m. Fri-
set for Friday day at the Jefferson County Library,
620 Cedar Ave., Port Hadlock.
• BY STUART ELLIOTT Membership listed
PENINSULA DAILY NEWS
Group members are Paul
Jefferson County has formed a Heinzinger and Rita Kepner of Mar-
citizens committee to help develop a rowstone Island; David Sullivan and
• solution to saltwater intrusion into Dick Broders of Discovery Bay; Com-
private water wells. missioner Wayne King of Public
And the committee begins its Utility District No. 1; Tom McNerny
quest at its first meeting Friday of the Jefferson County Planning
The nine-member committee was Commission; Dana Roberts of the
formed for a program to monitor Water Resource Inventory Area No.
seawater seepage after the Western 17 Planning Unit; Joe Baisch of
Washington Growth Management Brinnon; and Colette Kostelec of
Hearings Board rapped the county Port Townsend.
in January. The hearings board ruling was the
Commissioners had earlier result of a complaint filed by the
rejected staff recommendations on Olympic Environmental Council and
how to deal with the problem, and the Shine Community Action Council.
decided to seek input from the pub- Commissioners earlier rejected
lic on the issue. three options proposed by staff as a
New rules on saltwater intrusion response to the ruling.
must be in place by Aug. 11, said One option included requiring
county Natural Resources Manager applicants in critical seawater intru-
Dave Christiansen. sion areas to submit a certification
The issue largely revolves around from a licensed geologist. A second
the sharing of resources, and option would have included
whether a well drawing water will installing a flow meter as a condition
contribute to saltwater contamina- for issuing a building permit.
tion of a nearby well.. Under a third option, Jefferson
The issue includes to what extent County would manage water
Jefferson County is charged with resources completely.
411 ? -0 2.
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•
Board of Health
Old Business
Agenda Item # IV. , 2
IP Results on BRF55 Update
April 18, 2002
•
•
• , •'
. Jefferson County Health Human Human Services
•T JI r, l �iiikk615 SHERIDAN • PORT TOWNSEND,WA 98368 • FAX 360-385-9401
i r.
April 16, 2002
TO: Board of Health
FROM: Kellie Ragan
SUBJECT: BRFSS Modules
Enclosed are the following:
• Basic Demographic Characteristics of Respondents
• Environmental Health Module
• 18-34 Year Olds
• Revised Risk and Predictive Behavior BRFSS Module. The March 21, 2002 version
contained errors related Figure 7. Please recycle the March 21 version.
Please contact Jean or myself if you need additional information.
•
•
COMMUNITY ENVIRONMENTAL NATURAL DEVELOPMENTAL SUBSTANCE ABUSE
HEALTH HEALTH RESOURCES DISABILITIES &PREVENTION
360/385-9400 360/385-9444 360/385-9444 360/385-9400 360/385-9400
April 16, 2002
• Jefferson County 2001 BRFSS
Basic Demographic Characteristics of Respondents
Gender and Age. The 603 respondents to Jefferson County's 2001 Behavioral Risk
Factor Survey System (BRFSS) questionnaire included 292 men (48.5%) and 311
women (51.5%). They ranged in age from 18 to 94 (Figure 1). The average (mean) age
was 52.5 years, median age was 52, and modal age was 50. Based on the 2000
census, this is approximately the same distribution and average age as that seen in the
county's population age 18+ (compare Figures 1 and 2). However, to be certain that the
sample approximates the adult population, the sample was weighted to match age and
gender to the county's 2001 projected population. All data in this report have been
weighted. Respondents were grouped by age following the standard procedures of the
Centers for Disease Control and Prevention (CDC) methodology, which splits BRFSS
samples in three groups for small areas, 18-34, 35-64, and 65+. For Jefferson County,
15.5% were 18-34, 58.2% were 35 to 64, and 25.9% were 65+. Three people refused
to give their ages.
Education. Eight respondents had completed only grade 8 or less, 34 had some high
school (grades 9 to 11), and 146 had completed high school. Another 182 had one to
three years' post-secondary education, and 229 had completed four years or more of
college. Two people refused to answer the education question. For analysis,
respondents were grouped as having a high school education or less (189 people,
31.3% of the sample (Figure 3), some post-secondary (182 people, 30.3% of the
sample, and four or more years of college (229 people, 38.1% of the sample).
Educational attainment data from the 2000 census are not yet available, and so
education levels of the sample cannot yet be compared with those of the adult
population of the county but will be when they are available.
•
7
s
•
•
April 16, 2002
• Marital status and presence of children. Most of the respondents were married
(68.4%), 12.3% were divorced, 5% were widowed, 1.4% were separated, 7.9% had
never been married, and 4.7% were part of an unmarried couple. Two people refused
to answer the question about marital status. It was not possible to make so detailed a
comparison between the sample and the county, but when the comparison is between
married couples and all others, more of the sample were in married couple households
than in the county overall (68.6% vs. 53.6%, Figure 4). Four hundred and 23 people
(70.3% of the sample) had no children younger than 18 living at home, and 179 (29.7%)
did. When marital status and the presence of children are combined, the sample more
closely approximates the county (Figure 5): 23% of the sample were married couples
with children younger than 18 compared with 16.0% of the county, 45.6% of the sample
are married couples without children compared with 37.6% of the county, 6.7% are
other household types with children compared with 8.8% of the county, and 24.6% are
other households without children compared with 37.6% of the county.
4111
Residence. Two hundred and ninety one people (48.2%) lived in the 98368 ZIP code.
Three hundred and eleven (51.7%) respondents lived in all other ZIP codes. This is
approximately what would be expected given the geographic distribution of the county's
population.
Income. Efforts to get useable information about income were unsuccessful because
34 people said they did not know their income (5.7%) and another 48 (8.0%) refused to
answer no matter how the question was rephrased. Grouped education level was used
in BRFSS analyses as a measure of socioeconomic standing; this is standard practice
because non-response rates are typically so high when the question is income that it
often cannot be used as a measure of economic well-being. The income distribution of
respondents, like the education data, suggests they were rather well off. Among those
who did respond, 48 (8.0% of the sample) said it was below $15,000, 85 (14.1%) said it
was $15,000 but less than $25,000, 67 (11.0%) said it was $25,000 but less than
1111
2
April 16, 2002
• $35,000, 125 people (20.8% said it was $35,000 but less than $50,000, 112 people
(18.5%) said it was $50,000 but less than $75,000, and 84 (13.9%) said it was $75,000
or more (Figure 6). Census 2000 income data for the county have not yet been
released.
Employment. When asked about their current occupation, 220 people (36.5%) said
they were currently employed for wages and another 85 (14.0%) said they were self-
employed. Twenty-nine people (4.8%) were unemployed but wanted to work, another
54 (9.0% described themselves as homemakers, 11 (1.9%) were students, 24 (3.9%)
were unable to work, and 177 (29.4%) were retired.
Work place and travel time. Only those currently working were asked about their
place of employment and commuting times. Three-quarters of the sample worked in
Jefferson County: 141 people (46.4%) worked in Port Townsend, and another 75
• (24.6%) worked elsewhere in Jefferson County. Four people worked in Clallam County,
19 in Kitsap County, and 52 in other places. Thirteen people said their place of
employment varied so much they could not name one place. Travel time to work
ranged from one minute to eight hours. The nine people listing commutes of two hours
or longer all worked in some kind of extraction industry. When that group was excluded
from analysis, average (mean) commuting time one-way from home to work was 17.8
minutes, median was 10 minutes, and mode was 5 minutes. Again, detailed data from
the 2000 census have not yet been released, and so it is not possible to determine how
closely this information matches that for the general population of the county.
Recent in-migration. Seventy-one percent of adults surveyed in the Jefferson County
BRFSS had lived here five years ago, 5% lived in King County, 10% lived in another
Washington County, 5% lived in California, and 9% lived in some other state or foreign
country (Figure 7). The older the respondent, the more likely he or she was to have
lived here five years ago: 63% of 18-34 year olds, 69% of those age 35-64, and 83% of
3
•
April 16, 2002
• those age 65 and older had all lived here five or more years (Figure 8). More recent
arrivals tended to have more education: 80% of those with a high school education or
less had lived here at least five years as did 72% of those with some post-secondary
education but only 64% of those who had completed at least four years of college
(Figure 9). There were no statistically significant associations by gender or ZIP code of
residence.
•
4
Draft 4/16/02
Jefferson County 2001 BRFSS
Environmental Health
The Environmental Health module focused several topics: outdoor and indoor air
quality, discomforts related to poor air quality, source(s) of home heating, source(s) of
home drinking water, well water testing, sewage disposal system, and solid waste
disposal. Several questions have been omitted from analysis due to limited numbers of
responses.
Respondents were asked which of the following contribute to poor air quality: exhaust
fumes, industry, trash or garbage burning, wood stoves, burning land-clearing debris,
and agriculture dust.
• Jefferson County adults overall reported that industry contributed to poor air quality
(33%). This rate is significantly higher than Kitsap County (10%) (Figurel).
• Jefferson County adults overall reported that trash or garbage burning contributed to
poor air quality (12%). This rate is significantly lower than Kitsap County (19%)
(Figurel).
• Among the other contributors to poor air quality, there were no additional significant
differences between Jefferson and Kitsap County respondents.
• Twenty-five percent of ZIP Code 98368 respondents reported that transportation and
51% reported that industry contributes to poor air quality as compared to15% and
• 16% respectively in all other ZIP Codes; these differences are significant (Figure 2).
• Fifteen percent of all other ZIP code respondents reported that trash or garbage
burning contributes to poor air quality as compared to 9% of ZIP code 98368
respondents; this difference is significant (Figure 2).
• Nineteen percent of Jefferson County respondents reported discomfort (such as
headaches, shortness of breath, breathing trouble or coughing) related to outdoor air
quality (Figure 3). This is significantly higher (worse) than the 15% reported by
Kitsap County residents.
Jefferson County respondents reported differences of seasonal symptomatic
experiences of discomfort (Figure 4).
• During the summer months, 15% of Jefferson County adults reported experiencing
symptoms of discomfort. This is significantly lower than Kitsap County (26%).
• During the fall/winter months, 18% Jefferson County adults reported discomfort. This
is significantly lower than Kitsap County (24%).
• Year-around discomfort was reported by 22% of the Jefferson County adults. This is
significantly higher Kitsap County (15%).
• Occasional discomfort was reported by 20% of Jefferson County adults. This is
significantly higher than the Kitsap County (8%).
• Twenty-two percent of ZIP Code 98368 respondents reported that they had
experienced discomfort from INDOOR air as compared to 15% of all other ZIP
Codes; this difference is significant (Figure 6).
1
•
r
Draft 4/16/02
• Overall, there were no significant differences between Jefferson and Kitsap County
• respondents reporting on discomfort (such as headaches, shortness of breath,
breathing trouble or coughing) related to indoor air quality (Figure 5).
• However, 26% of Jefferson County respondents reported symptoms from indoor
discomfort in the workplace/other as compared to 32% of Kitsap County adults
(Figure 7). Additionally, 27% of Jefferson County adults reported symptoms related
to indoor air discomfort in public buildings/other as compared to the Kitsap County
rate of 31%. Jefferson County rates are significantly lower (better) than Kitsap
County.
Respondents were asked to identify primary sources of heat for their homes.
• Three percent of the Jefferson County adults reported natural gas the primary
source of heat for their homes as compared to 24% in Kitsap County (Figure 8).
• 6% percent of county adults reported oil as the primary source of home heat
compared to 10% in Kitsap County (Figure 8).
• 16% of county adults reported propane or propane-powered heat as the primary
source of home heat as compared to 8% in Kitsap County (Figure 8).
• and 20% of Jefferson County adults reported wood stoves as the primary source of
heat for their homes as compared to 5% in Kitsap County (Figure 8).
• All of the above differences are significant
• . ZIP Code 98368 respondents were significantly more likely to report the use
electricity (59%) or propane/propane-powered/natural gas (28%) as a primary
source of home heat as compared to all other ZIP Codes (50% and 22%
respectively). Twenty-eight percent of those in all other ZIP codes reported use of
wood heat as the primary source of home heat as compared to 13% in ZIP code
98368. This difference is significant (Figure 9).
Jefferson County respondents were asked several questions about home drinking
water.
• Fifty-three percent of the Jefferson County respondents reported city/district as their
home water supply. This is significantly lower than Kitsap County (66%) (Figure 10).
• 29% of Jefferson County adults identified a private well as their home source of
drinking water. This is significantly higher than Kitsap County (23%).
• 18% of Jefferson County adults identified a community system or other source as
their home source of drinking water. This is significantly higher than Kitsap County
(11%).
. Eighty percent of ZIP code 98368 respondents reported city or district source as
their home's source of drinking water (Figure 11). Conversely, 48% of all other ZIP
codes reported a private well as their home's source of drinking water. These
differences are significant
•
2
Draft 4/16/02
There were no significant differences between Jefferson and Kitsap responses to the
• question regarding if well water has ever been tested or whether well testing indicated
the presence of contaminants (Figures 12 and 14).
However, there were significant differences regarding well water testing.
• 54% of Jefferson County adults reported that their water had been tested within the
last 3 years. This is significantly lower than Kitsap County (71%).
• 46% of Jefferson County adults reported that their water had been tested greater
than 3 years ago which is higher than the 29% of Kitsap respondents (Figure 13).
Jefferson County respondents were also asked several questions about sewer/septic
systems.
• 40% of Jefferson County adults reported that they were on a municipal sewer
system and 60% utilize septic tank/drain field systems as compared to 44% and
56% respectively in Kitsap County. These differences are significant (Figure 15).
• 63% of Jefferson County adults reported that they had their septic tank pumped
within the last 3 years and 7% reported their tank being pumped 4-5 years ago as
compared to Kitsap County rates of 49% and 7% respectively (Figure 17). These
differences are significant.
. • 64% of ZIP code 98368 respondents reported municipal sewer as their sewage
disposal system; 80% of all other ZIP codes reported septic tank or drain field as
their sewage disposal system. These differences are significant (Figure 16).
The final environmental health module questions pertained to solid waste disposal.
• 90% of Jefferson County adults reported a solid waste disposal service in their
community as compared to 99% of Kitsap respondents (Figure 18).
• 94% of Zip code 98368 reported knowing about a solid waste disposal service in
their community as compared to 87% of all other ZIP codes (Figure 19).
• 73% of Jefferson County respondents reported using the solid waste disposal
service as compared to 87% of Kitsap County respondents (Figure 20).
• 85% of ZIP code 98368 reported using a solid waste disposal service as compared
to 60% of all other ZIP codes (Figure 21); this difference is significant.
•
3
•
•
i
DRAFT
Figure 1. (Q26x1--Q26x7) Do any of the the following items contribute to poor air quality
in your area? Jefferson County BRFSS, 2001 and Kitsap County BRFSS, 1998.
Jefferson County Kitsap County
Exhaust fumes 20% 23%
Industry''* 33% 10%
Trash or garbage burning* 12% 19%
Wood stoves 30% 29%
Burning/land-clearing debris 15% 17%
Agricultural dust 3% 4%
Figure 1 . Do any of the following items
contribute to poor air quality in your area*.
Jefferson County 2001
and Kitsap County 1998 BRFSS
100% - Source: Jefferson County Department of Health&Human Services BRFSS,2001
and Kitsap County BRFSS, 1998
90% -
80% - Jefferson County El Kitsap County
70% -
60% -
50% -
40% -
33%
30%29%
30% -
23
20% 19%
20% - 15%17%
10% 12%
10% -
3% 4%
MMI
0%
Exhaust Industry** Trash or Wood stoves Burnin Agricultural
fumes garbage g/land- dust
burning* clearing
debris
**Jefferson County is significantly higher *Jefferson County is significantly lower
4/11/02
DRAFT
Figure 2. (Q26x1--Q26x7) Do any of the the following items contribute to poor air
quality in your area, by ZIP code*. Jefferson County 2001 BRFSS.
Jefferson County
The following contribute to poor air quality ZIP Code 98368 All other ZIP Codes
Transportation Exhaust** 25% 15%
Industry* 51% 16%
Trash or Garbage Burning** 9% 15%
Wood Stoves NS NS
Dust or Smoke from buring land clearing debris NS NS
Agricultural Dust NS NS
Figure 2. Which of the following items
contribute to poor air quality in your area,
by ZIP code*.
Jefferson County 2001 BRFSS
Source: Jefferson County Department of Health&Human Services,2001 BRFSS.
NI ZIP Code 98368 DAD other ZIP Codes
100% -
90% -
80% -
70% -
60% -
51%
50% -
40% -
30% - 25%
20% - 15% 16% 15%
10% -
0%
Transportation Exhaust** Industry* Trash or Garbage
Burning**
*Difference is statiscically significant,p<.001 **Difference is statiscically significant,p<.05.
4/11/02
DRAFT
Figure 3. (Q26x10) Have you experienced discomfort due to pollutants in the outside air such as
. headaches, shortness of breath, breathing trouble or coughing?Jefferson County BRFSS, 2001
and Kitsap County BRFSS, 1998
Jefferson County Kitsap County
Percent Percent
Yes** 19% 15%
No 81% 85%
Figure 3. Have you experienced discomfort
due to pollutants in the outside air such as... *,
Jefferson County 2001 and Kitsap County
1998 BRFSS
Source: Jefferson County Department of Health&Human Services BRFSS,2001
and Kitsap County BRFSS, 1998
■Jefferson County ❑Kitsap County
100% -
• 90% - 85%
81%
80% -
70% -
60% -
50% -
40% -
30% -
20% 19%
15%
10% -
0% I
1
Yes** No
• **Jefferson County is significantly higher
4/11/02
DRAFT 4/11/02
Figure 4. (Q26x11) In which season do you experience these symptoms most often?
41) Jefferson County BRFSS, 2001 and Kitsap County BRFSS, 1998
Jefferson County Kitsap County
Spring 25% 27%
Summer* 15% 26%
Fall/Winter* 18% 24%
Year-round** 22% 15%
Occasionally** 20% 8%
Figure 4. In which season do you experience
symptoms of outdoor
pollution most often*,
Jefferson County 2001 and
Kitsap County 1998 BRFSS
100% Source: Jefferson County Department of Health&Human Services BRFSS,2001
and Kitsap County BRFSS, 1998.
90% -
•Jefferson County ❑Kitsap County
80% -
70% -
60% -
50% -
40% -
30% - 25%27% 26%
240/0
/o 22%
20%
20% - 15°/ 181% 15%
10% - 8%
0%
Spring Summer* Fall/Winter* Year-round** Occasionally**
**Jefferson County is significantly higher *Jefferson County is significantly lower
i
DRAFT
Figure 5. (Q26x12) Have you experienced discomfort from INDOOR air such as
headaches, shortness of breath, breathing trouble or coughing? Jefferson County BRFSS, 2001
and Kitsap County BRFSS, 1998.
Jefferson County Kitsap County
Percent Percent
Yes 18% 15%
No 82% 85%
Figure 5. Have you experienced discomfort
from INDOOR air such as ...,
Jefferson County 2001
and Kitsap County 1998 BRFSS
Source: Jefferson County Department of Health&Human Services BRFSS,2001
and Kitsap County BRFSS, 1998.
100% •Jefferson County
• 90% - ❑Kitsap County
82% 85%
80% -
70% -
60% -
50% -
40% -
30% -
20% - 18%
15%
10% -
0%
• Yes No
4/11/02
DRAFT
Figure 6. (Q26x12) Have you experienced discomfort from INDOOR air such as
• headaches, shortness of breath, breathing trouble or coughing, by ZIP Code*.
Jefferson County 2001 BRFSS
Jefferson County
ZIP Code 98368 All other ZIP Codes
Have experienced discomfort 22% 15%
Figure 6. Have you experienced discomfort
from INDOOR air such as headaches,
shortness of breath, breathing trouble or
coughing, by ZIP Code*.
Jefferson County 2001 BRFSS
Source: Jefferson County Department of Health&Human Services,2001 BRFSS.
■ZIP Code 98368 DAII other ZIP Codes
100% -
I 90% -
80% -
70% -
60% -
50% -
40% -
30% -
22%
20% -
15%
10% -
0%
Have experienced discomfort
. *Difference is statiscically significant,p<.05
4/11/02
DRAFT
Figure 7. (Q26x13)Where did these symptoms (of indoor pollution) occur?
Kitsap County BRFSS, 1998
Jefferson County Kitsap County
Home 48% 51%
Workplace/office* 26% 32%
Public building/Other* 27% 31%
Figure 7. Where did you experience
symptoms of indoor pollution*, Jefferson
County 2001 and
Kitsap County 1998 BRFSS
Source: Jefferson County Department of Health&Human Services BRFSS,2001 and
Kitsap County BRFSS, 1998.
100% -
•Jefferson County El Kitsap County
90% -
80% -
• 70% -
60% -
51%
50% - 48%
40% -
32% 31%
o _
° 26% 27%
20% -
10% -
0%
Home Workplace/office* Public
building/Other*
*Jefferson County is significantly lower
4/11/02
DRAFT
Figure 8. (Q26x14) What is the PRIMARY source of heat for your home, that is,
• the one you use most often? Jefferson County BRFSS, 2001 and
Kitsap County BRFSS, 1998.
Jefferson County Kitsap County
Electricity 54% 51
Natural Gas* 3% 24%
Oil* 6% 10%
Propane/propane-powered heat** 16% 5%
Wood buring stove** 20% 8%
Figure 8. What is the PRIMARY source of
heat for your home, that is, the one you use
most often?
Jefferson County 2001 and
Kitsap County 1998 BRFSS
Source: Jefferson County Department of Health&Human Services BRFSS,2001
and Kitsap County BRFSS, 1998.
100% -
■Jefferson County ❑Kitsap County
• 90% -
80% -
70% -
60% - 54%
51%
50% -
40% -
30% -
24%
20%
20% - 16%
%
6% 10%
10 5/o 0 8%
0% -
Electricity Natural Gas* Oil* Propane/propa Wood buring
ne-powered stove**
heat**
**Jefferson County is significantly higher *Jefferson County is significantly lower
S
4/11/02
DRAFT 4/11/02
Figure 9. (Q26x14)What is the PRIMARY source of heat for your home, that is,
the one you use most often? Jefferson County BRFSS, 2001.
Jefferson County
ZIP Code 98368 All other ZIP Codes
Electricity 59% 50%
Propane/propane-powered heat/natural gas 28% 22%
Wood buring stove/other 13% 28%
Figure 9. What is the PRIMARY source of
heat for your home, that is, the one you use
most often, by ZIP Code*.
Jefferson County BRFSS, 2001 .
Source: Jefferson County Department of Health&Human Services BRFSS,2001.
100% - ■ZIP Code 98368 ❑All other ZIP Codes
90% -
80% -
70% -
60% - 59%
50%
50% -
40% -
30% - 28% 28%
22%
20% -
13%
10% -
0%
Electricity Propane/propane-powered Wood buring stove/other
heat/natural gas
• *Difference is statiscically significant,p<.001
DRAFT
Figure 10. (Q26x17) What is the source of your home's drinking water?
• Jefferson County BRFSS,2001 and Kitsap County BRFSS, 1998
Jefferson Couni Kitsap County
Percent Percent
City/district supply* 53% 66%
Private well** 29% 23%
Community system/other** 18% 11%
Figure 10. What is the source of your home's
drinking water?
Jefferson County 2001
and Kitsap County 1998 BRFSS
Source: Jefferson County Department of Health&Human Services BRFSS,2001 and
Kitsap County BRFSS, 1998.
100% -
90% -
80% -
• Jefferson County
70% - 66% ❑Kitsap County
60% -
53%
50% -
40% -
30% - 29%
23%
20% - 18%
11%
10% -
0%
City/district supply* Private well** Community system/other**
**Jefferson County is significantly higher *Jefferson County is significantly lower
•
4/11/02
DRAFT
Figure 11. (Q26x17) What is the source of your home's drinking water, by ZIP Code*.
• Jefferson County BRFSS,2001.
Jefferson County
ZIP Code 98368 All other ZIP Codes
City or District Supply 80% 28%
Community System/other 11% 24%
Private Well 9% 48%
Figure 11 . What is the source of your home's
drinking water, by ZIP Code*.
Jefferson County BRFSS, 2001 .
Source: Jefferson County Department of Health&Human Services BRFSS,2001.
100% -
90% - ■ZIP Code 98368
• 80% - 80% ❑AII other ZIP Codes
70% -
60% -
50% - 48%
40% -
30% - 28%
24%
20% -
11%
10% 9%
0%
City or District Supply Community System/other Private Well
*Difference is statiscically significant,p<.001
4/11/02
DRAFT
Figure 12. (Q26x18) Has your well water ever been tested?
11) Jefferson County BRFSS, 2001and Kitsap County BRFSS, 1998
Jefferson County Kitsap County
Yes 92% 92%
No 8% 8%
Figure 12. Has your well ever
been tested? Jefferson County 2001 and
Kitsap County 1998 BRFSS
Source: Jefferson County Department of Health&Human Services BRFSS,2001 and
Kitsap County BRFSS, 1998.
100% ■Jefferson County ❑Kitsap County
92% 92%
90% -
80% -
• 70% -
60% -
50% -
40% -
30% -
20% -
10% - 8% 8%
0% 1E7
Yes No
•
4/11/02
DRAFT
Figure 13. (Q26x18) About how long has it been since(your well)was tested?
• Jefferson County BRFSS, 2001 and Kitsap County BRFSS, 1998.
Jefferson County Kitsap County
Within 3 years* 54% 71%
Greater than 3 years ago** 46% 29%
Figure 13. How long has it been since your well
was tested? Jefferson County 2001 and
Kitsap County 1998 BRFSS
Source: Jefferson County Department of Health&Human Services BRFSS,2001
and Kitsap County BRFSS, 1998.
80% -
71% ■Jefferson County
70% ❑Kitsap County
60% -
. 54%
50% -
46%
40% -
30% - 29%
20% -
10% -
0%
Within 3 years* Greater than 3 years ago**
**Jefferson County is significantly higher *Jefferson County is significantly lower
411
4/11/02
DRAFT 4/11/02
Figure 14. (Q26x19) Did the results from well testing indicate the presence of
• any contaminants? Jefferson County BRFSS, 2001 and Kitsap County BRFSS, 1998
Jefferson County Kitsap County
Yes 7% 7%
No 93% 93%
Figure 14. Did well testing show contaminants?
Jefferson County 2001 and
Kitsap County 1998 BRFSS
Source: Jefferson County Department of Health&Human Services BRFSS,2001
and Kitsap County BRFSS, 1998.
IN Jefferson County D Kitsap County
100% -
93% 93%
90% -
80% -
• 70% -
60% -
50% -
40% -
30% -
20% -
10% - 7% 7%
0% 111-7
Yes No
DRAFT
Figure 15. (Q26x20) What kind of sewage disposal system does your home use?
410 Jefferson County BRFSS, 2001 and Kitsap County BRFSS, 1998.
Jefferson County Kitsap County
Municipal sewer* 40% 44%
Septic tank/drain field** 60% 56%
Figure 15. What kind of sewage disposal system
does your home have?
Jefferson County 2001
and Kitsap County 1998 BRFSS
Source: Jefferson County Department of Health&Human Services BRFSS,2001
and Kitsap County BRFSS, 1998.
100% -
■Jefferson County El Kitsap County
90% -
80% -
• 70% -
60%
60% - 56%
50% -
44%
40%
40% -
30% -
20% -
10% -
0%
Municipal sewer* Septic tank/drain field**
**Jefferson County is significantly higher *Jefferson County is significantly lower
•
4/11/02
•
DRAFT
Figure 17. (Q26x20) What kind of sewage disposal system does your home use, by ZIP Code.
• Jefferson County BRFSS, 2001.
Jefferson County
ZIP Code 98368 All other ZIP Codes
Municipal Sewer 64% 20%
Septic Tank or drain field 36% 80%
Figure 16. What kind of sewage disposal
system does your home use,
by ZIP Code*.
Jefferson County BRFSS, 2001 .
Source: Jefferson County Department of Health&Human Services BRFSS,2001.
100% - ■ZIP Code 98368 ❑AII other ZIP Codes
90% -
80%
80% -
• 70% -
64%
60% -
50% -
40% - 36%
30% -
20%
20% -
10% -
0%
Municipal Sewer Septic Tank or drain field
*Difference is statiscically significant,p<.001
4/11/02
DRAFT
Figure 17. (Q26x21) When was the last time your septic tank was cleaned or pumped?
• Jefferson County BRFSS, 2001 and Kitsap County BRFSS, 1998.
Jefferson County Kitsap County
Within 3 years** 63% 49%
4-5 years ago* 7% 19%
Over 5 years ago 13% 14%
Never 17% 17%
Figure 17. How long since your septic tank
was cleaned/pumped? Jefferson County
2001 and Kitsap County 1998 BRFSS
100% -
Source: Jefferson County Department of Health&Human Services BRFSS,2001 and
Kitsap County BRFSS, 1998.
90% -
■Jefferson County ❑Kitsap County
80% -
70% -
411 63%
60% -
50% 49%
40% -
30% -
° 19%
20% - 17% 17%
13% 14%
10% - 7%
11-1
0% ,
Within 3 years** 4-5 years ago* Over 5 years ago Never
**Jefferson County is significantly higher *Jefferson County is significantly lower
4/11/02
DRAFT
Figure 18. (Q26x23) Is there a solid waste disposal service...in your community?
• Jefferson County BRFSS, 2001 and Kitsap County BRFSS, 1998.
Jefferson County Kitsap County
Yes* 90% 99%
No** 10% 1%
Figure 18. Is there a solid waste disposal
service in your community?
Jefferson County 2001 and
Kitsap County 1998 BRFSS
Source: Jefferson County Department of Health&Human Services BRFSS,2001 and
Kitsap County BRFSS, 1998.
100% - 99%
■Jefferson County
90% ❑Kitsap County
90% -
• 80% -
70% -
60% -
50% -
40% -
30% -
20% -
10%
10% -
II 1%
0%
Yes* No**
**Jefferson County is significantly higher *Jefferson County is significantly lower
•
4/11/02
DRAFT 4/11/02
Figure 19. (Q26x23)) Is there a solid waste disposal service, such as...,
• by ZIP code*. Jefferson County BRFSS, 2001.
ZIP code 98368 All other ZIP codes
Yes 94% 87%
No 6% 13%
Figure 19. Is there a solid waste dispostal
service, by ZIP code*.
Jefferson County BRFSS, 2001 .
Source: Jefferson County Department of Health&Human Services BRFSS,2001.
III ZIP code 98368 El All other ZIP codes
100% -
94%
90% - 87%
80% -
• 70% -
60% -
50% -
40% -
30% -
20% -
13%
10% - 6%
0%
Yes No
Difference is significant,p<.05
•
DRAFT 4/11/02
Figure 20. (Q26x23) Do you use a solid waste disposal service, such as...?
• Jefferson County BRFSS, 2001 and Kitsap County BRFSS, 1998
Jefferson County Kitsap County
Yes 73% 87%
No 27% 13%
Figure 20. Do you use a solid waste disposal
service?
Jefferson County 2001 and
Kitsap County 1998 BRFSS
Source: Jefferson County Department of Health&Human Services BRFSS,2001 and
Kitsap County BRFSS, 1998.
100% -
90% - 87%
III Jefferson County
80% - D Kitsap County
73%
70% -
60% -
50% -
40% -
30% - 27%
20% -
13%
10% -
0%
Yes No
•
DRAFT
Figure 21. (Q26x24)) Do you use a solid waste disposal service, such as...,
4" by ZIP code*. Jefferson County BRFSS, 2001.
ZIP code 98368 All other ZIP codes
Yes 85% 60%
No 15% 40%
Figure 21 . Do you use a solid waste disposal
service, by ZIP code*. Jefferson County
BRFSS, 2001 .
Source: Jefferson County Department of Health&Human Services BRFSS,2001.
100% -
90% - ■ZIP code 98368
85%
DAD other ZIP codes
80% -
70% -
IP
60%
60% -
50% -
40%
40% -
30% -
20% -
15%
10% -
0% I
Yes No
Difference is significant,p<.05
•
4/1 1/02
4/16/2002
Jefferson County 2001 BRFSS
Respondents age 18-34 years old
Respondents who were 18 to 34 years old experienced significantly more
health access problems than either older county residents or state residents
age 18-34 but were less likely to keep firearms around their homes, to be
overweight, or to be physically inactive than older people.
• Respondents were asked their age. Ninety-three were 18 to 34 years old, or
about 16% of the sample.
• One finding of the BRFSS was that households including children younger
than 18 had unusually dense concentrations of adults who reported health
care access problems and who smoke, drink heavily, and themselves have
childhood histories of abuse. The group which is the focus of this analysis,
the 18-34 year olds, are not identical to respondents in households with
children younger than 18: 178 households had children younger than 18, and
in 50 of them (28%), the respondent was 18-34 years old. Of the 93
respondents age 18-34, 43 (46%) reported their households included children
younger than 18 and 50 (54%) reported their households did not.
•
• Eighty-nine percent of respondents age 18-34 said their general health was
excellent, very good, or good (Figure 1). This rate is significantly lower than
the state rate for that age group (93%), about the same as that reported for
state and county residents age 35-64, and significantly higher than the rate
among state and county residents age 65+.
• Only 74% of county residents age 18-34 had any kind of health care coverage
(Figure 2). This rate is significantly lower than the state rate for this age
group (84%) and also significantly lower than the rate reported by county
respondents age 35-64 (91%) or 65+ (99%).
• Only two-thirds of county residents age 18-34 have a health care provider
they usually go to (Figure 3), significantly lower than the rate for residents age
35-64 (85%) or 65+ (94%). Comparable state data will be available in the
summer of 2002.
• Only 74% of county residents age 18-34 have a particular place they usually
go to get health care, significantly lower than people age 35-64 (89%) or
people age 65+ (93%, Figure 4). Comparable state data will be available in
the summer of 2002.
4/16/2002
• Respondents age 18-34 reported the significantly higher rates of dental
• insurance: 69% of them had dental insurance compared with 60% of people
age 35-64 and only 29% of those age 65+.
. However, 63% of county residents age 18-34 made a dental visit within the
past year, significantly lower than the rate among people age 35-64 (76%) or
65+ (70%, Figure 7).
. Only 59% of county residents age 18-34 had their teeth cleaned within the
past year, significantly lower than the state rate in that age group, 68%
(Figure 8). In both the county and state, rates of having teeth cleaned were
significantly lower in this age group than in other age groups.
• Twenty-one percent of country respondents age 18-34 keep guns in or
around their homes, a significantly lower rate than that in other age groups
(Figure 9). Comparable state data will be available in the summer of 2002.
• County residents age 18-34 had a significantly lower rate of being at risk for
health problems from being overweight (16%) than the state average (31%,
Figure 10). County rates of being at risk were significantly higher in other age
groups but were significantly lower than the state average.
. Smoking rates were significantly higher among county residents age 18-34
• (28%) than among those age 35-64 (19%) or 65+ (5%, Figure 11). The
county's age-specific rate is higher among those age 18-34 but lower among
those in the two other age groups.
• In every age group, significantly more county residents consumed alcohol
within the previous 30 days (Figure 12). The rate is highest among people
age 18-34 both in the county and in the state.
• In the county, people age 18-34 are significantly less likely to be physically
inactive (Figure 13). Comparable state data will be available in the summer
of 2002.
S
DRAFT
Figure 1. (Q1X1) Self-reported health status is excellent, very good, or good
Jefferson County 2001 and Washington State 2000 BRFSS, by age
Jefferson County Washington State
18-34 years old* 89% 93%
35-64 years old 87% 89%
65+years old 76% 77%
Figure 1. Self-reported health status is excellent, very
good, or good, by age*, Jefferson County 2001 and
Washington 2000 BRFSS
Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;
Washington State 2000 BRFSS,CDC website
100%
Jefferson County ❑Washington State
-
93%
90% 89% 89%
87%
80% -
76% 77%
• 70% -
60% -
50% -
40% -
30% -
20% -
10% -
0%
18-34 years old* 35-64 years old 65+years old
*Among 18-34 year olds, county rate is significantly lower(worse)than state rate;in both state and county,
rate in this age group is significantly lower than in other age groups
•
4/16/02
•
DRAFT
Figure 2. (Q2X1) Have any kind of health care coverage, by age
Jefferson County 2001 and Washington State 2000 BRFSS
Jefferson County Washington State
18-34 years old 74% 84%
35-64 years old 91% 91%
65+years old 99% 99%
Figure 2. Have any kind of health care coverage, by age*.
Jefferson County 2001 and Washington 2000 BRFSS
Source: Jefferson County- Department of Health& Human Services,2001 BRFSS;
Washington State 2000 BRFSS-CDC website
■Jefferson County ❑Washington State 99% 99%
100% -
91% 91%
90% -
84%
80% -
74%
•
70% -
60% -
50% -
40% -
30% -
20% -
10% -
0%
18-34 years old 35-64 years old 65+years old
*Among 18-34 year olds,county rate is significantly lower(worse)than state rate;in both state and county,
rate in this age group is significantly lower than in other age groups
•
4/16/02
DRAFT
Figure 3. (Q2x6) Is there one doctor or health provider that you usually go to, by age
• Jefferson County 2001 BRFSS
Is there one doctor or health provider that you usually go to,
18-34 years old 67%
35-64 years old 85%
65+years old 94%
Figure 3. Is there one doctor or health provider that you
usually go to, by age*. Jefferson County 2001 BRFSS
Source: Jefferson County- Department of Health&Human Services,2001 BRFSS
100% -
94%
90% -
85%
80% -
70% - 67%
•
60% -
50% -
40% -
30% -
20% -
10% -
0%
1
18-34 years old 35-64 years old 65+ years old
*Rate among 18-34 year olds is significantly lower(worse)than rates in other age groups.
III
4/16/02
DRAFT
Figure 4. (Q19x1) Is there one particular clinic, health center, doctor's office, or other place
• that you usually go if you are sick or need advice about your health, by age
Jefferson County 2001 BRFSS
Have one particular place you go to for care
18-34 years old 74%
35-64 years old 89%
65+ years old 93%
Figure 4. Have one particular place you go to for care, by
age*. Jefferson County 2001 BRFSS
Source: Jefferson County- Department of Health&Human Services,2001 BRFSS
100% -
93%
89%
90% -
80% -
74%
•
70% -
60% -
50% -
40% -
30% -
20% -
10% -
0%
18-34 years old 35-64 years old 65+ years old
*Rate among 18-34 year olds is significantly lower(worse)than rates in other age groups.
•
4/16/02
DRAFT
Figure 5. (Q19x5) How long has it been since you last visited a doctor for a routine checkup,
41) by age. Jefferson County 2001 BRFSS
Jefferson County Washington State
18-34 years old 64% 64%
35-64 years old 73% 66%
65+years old 84% 82%
Figure 5. Had routine checkup in last year,
by age*, Jefferson County 2001 and Washington State
2000 BRFSS
Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;
Washington State 2000 BRFSS-CDC website
100% -
90% -
84%
82%
80% -
• 73%
70% 64% 64% 66%
60% -
50% -
40% -
30% -
20% -
10% -
0%
18-34 years old 35-64 years old 65+ years old
*In both the state and county,rates are significantly lower(worse)for 18-34 year olds and higher(best)for those 65+;rate
among 35-64 year olds in county is significantly higher in county than in state..
4/16/02
DRAFT
• Figure 7. (Q21x1) How long has it been since you last visited a dentist or a dental clinic
for any reason, by age. Jefferson County 2001 BRFSS and
Washington State 1999 BRFSS
Jefferson County Washington State
18-34 years old 63% 65%
35-64 years old* 76% 70%
65+ years old* 70% 63%
Figure 7. Dental visit for any reason within the past year,
by age*, Jefferson County 2001 and Washington State
1999 BRFSS
Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;
Washington State data from CDC website
100% -
■Jefferson County ❑Washington State
90% -
80% - 76%
• 70% 70%
70% 65%
63% 1 63%
60% -
50% -
40% -
30% -
20% -
10% -
0% i
18-34 years old 35-64 years old* 65+ years old*
*In both the state and county, rates are significantly lower(worse)for 18-34 year olds.
4/16/02
•
DRAFT
• Figure 8. (Q21x3)Teeth were cleaned in past year by dentist or dental hygenist,
by age, Jefferson County 2001 BRFSS and Washington State 1999 BRFSS
Jefferson County Washington State
18-34 years old* 59% 68%
35-64 years old 75% 76%
65+years old* 72% 79%
Figure 8. Had teeth cleaned within the past year, by
age*, Jefferson County 2001 BRFSS and Washington
1999 BRFSS
Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;
Washington State 2000 BRFSS,CDC website
100% -
■Jefferson County ❑Washington State
90% -
80% -
75/0 0 76% 79%
•
72%
70% - 68%
60% - 59%
50% -
40% -
30% -
20% -
10% -
0%
18-34 years old* 35-64 years old 65+ years old*
*Among 18-34 year olds and those 65+, county rates are significantly lower(worse)than state rate;in both
state and county,rates among 18-34 year olds are significantly lower than in other age groups
4/16/02
DRAFT
• Figure 9. Are any firearms now kept in or around your home?
Jefferson County 2001 BRFSS
Jefferson County Washington State
18-34 years old* 22% n/a
35-64 years old* 42% n/a
65+years old* 44% n/a
Figure 9. Firearms are kept in or around home,
by age*, Jefferson County 2001 BRFSS
Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;
100% -
90% -
80% -
70% -
•
60% -
50% -
42% 44%
40% -
30% -
22%
20% -
10% -
0%
18-34 years old* 35-64 years old* 65+ years old*
*People age 18-34 have significantly lower rates than those in other age groups.
•
4/16/02
DRAFT
Figure 10. (Q21x3)At risk of health problems from being overweight(modified BMI)
• by age, Jefferson County 2001 BRFSS and Washington State 2000 BRFSS
Jefferson County Washington State
18-34 years old 16% 31%
35-64 years old 31% 37%
65+years old 31% 39%
Figure 10. At risk of health problems from being
overweight, by age*, Jefferson County 2001 and
Washington 2000 BRFSS
Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;
Washington State 2000 BRFSS,CDC website
100% -
90% -
80% -
• 70% -
60% -
50% -
•
40% - 37% 39%
31% 31% 31%
30% -
20% - 16%
10% -
0% i -
18-34 years old 35-64 years old 65+ years old
*In each age group,the county rates are significantly lower(better)than state rate;in both state and county,
rates among 18-34 year olds are significantly lower than in other age groups
•
4/16/02
DRAFT
Figure 11. Currently smokes cigarettes,
• by age,Jefferson County 2001 BRFSS and Washington State 2000 BRFSS
Jefferson County Washington State
18-34 years old 28% 24%
35-64 years old 19% 22%
65+ years old 5%
11%
Figure 11. Current smoker, by age*, Jefferson County
2001 and Washington 2000 BRFSS
Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;
Washington State 2000 BRFSS,CDC website
100% -
90% -
80% -
• 70% -
60% -
50% -
40% -
30% - 28%
24%
22%
20% 19%
11%
10% -
5
0%
18-34 years old 35-64 years old 65+ years old
*Among both county and state respondents,the rates among 18-34 year olds are significantly higher(worse);rates among
county residents are higher among 18-34 year olds but lower in other age groups.
•
4/16/02
DRAFT
Figure 12. Consumed alcohol within past 30 days,
by age, Jefferson County 2001 BRFSS and Washington State 1999 BRFSS
Jefferson County Washington State
18-34 years old 73% 68%
35-64 years old 68% 62%
65+years old 65% 47%
Figure 12. Consumed alcohol in past 30 days, by
age*, Jefferson County 2001 and Washington 1999
BRFSS
Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;
Washington State 2000 BRFSS,CDC website
100% -
90% -
80% -
73%
70% - 68% 68%
•
62% 65%
60% -
50% - 47%
40% -
30% -
20% -
10% -
0% ,
18-34 years old 35-64 years old 65+ years old
*Age-specific alcohol consumption rates are significantly higher in the county than in the state.
•
4/16/02
DRAFT
Figure 13. At risk of health problems from being physically inactive
by age,Jefferson County 2001 BRFSS and Washington State 2000 BRFSS
Jefferson County Washington State
18-34 years old 7%
35-64 years old 13%
65+years old 16%
Figure 13. At risk of health problems from being
physically inactive, by age*, Jefferson County 2001
and Washington 2000 BRFSS
Source: Jefferson County- Department of Health&Human Services,2001 BRFSS;
Washington State 2000 BRFSS,CDC website
100% -
90% -
80% -
• 70% -
60% -
50% -
40% -
30% -
20% -
16%
13%
10% - 7%
0%
18-34 years old 35-64 years old 65+ years old
*Rates among 18-34 year olds are significantly lower than in other age groups
•
4/16/02
S
April 16, 2002
TO: Board of Health
FROM: Kellie Ragan
SUBJECT: Risk and Predictive Behavior BRFSS Module
Enclosed is the revised Risk and Predictive Behavior BRFSS Module. The one that you
received on March 21, 2002 contained construct errors related Figure 7.
Please feel free to recycle the March 21 version.
Thank you.
•
•
• Figure 7. Physical inactivity among overweight respondents.
Jefferson County BRFSS, 2001.
Overweight Not Overweight
Physically Active 82% 90%
Physically Inactive 18% 10%
Figure 7. Physical inactivity among people
overweight by BMI*,
Jefferson County BRFSS, 2001
Source: Jefferson County Department of Health&Human Services BRFSS,2001
■ Physically Active ❑Physically Inactive
100% -
90%
90% -
82%
• 80% -
70% -
60% -
50% -
40% -
30% -
20% 18%
10%
10% -
0%
Overweight Not Overweight
*Difference is statistically significant,p<.05
•
4/16/02
Figure 6. Heavy drinking (5+/timer overweight.
•
Jefferson County BRFSS, 2001.
Heavy Drinker(5+/time)
Heavy Drinking No Heavy Drinking
Overweight by BMI 27% 73%
Not overweight 15% 86%
Figure 6. Heavy drinking (5+/time) and
overweight by BMI*,
Jefferson County BRFSS, 2001
Source: Jefferson County Department of Health&Human Services BRFSS,2001
100% -
90% - 86%
• 80% -
73%
70% -
60% -
50% -
40% -
I
30% - 27%
20% - 15%
10% -
0%
Heavy Drinking No Heavy Drinking
*Difference is statistically significant,p<.01
4/16/02
Figure 5. Heavy drinking (5+/time)`among current smokers.
•
Jefferson County BRFSS, 2001.
Heavy Drinker(5+/time)
Heavy Drinking No Heavy Drinking
Current Smoker 34% 66%
Non-Smoker 15% 85%
Figure 5. Heavy drinking (5+/time) and smoking*,
Jefferson County BRFSS, 2001
Source: Jefferson County Department of Health&Human Services BRFSS,2001
100% -
I
90% - 85%
IN Current Smoker ❑Non-Smoker
80% -
• 70% - 66%
60% -
50% -
40% -
34%
30% -
20% -
15%
10% -
0%
Heavy Drinking No Heavy Drinking
*Difference is statistically significant,p<.01
•
4/16/02
Figure 4. (Q11x3) Consumed 5+drinks of alcohol at least once in past 30 days
• Jefferson County 2001 BRFSS and Washington State 1999 BRFSS
Jefferson County* 17%
Washington State 23%
Figure 4. Consumed 5+ drinks of alcohol at
least once in past 30 days, Jefferson County
2001 BRFSS* and Washington State 1999
BRFSS
Source: Jefferson County Department of Health&Human Services,2001 BRFSS;Washington
State data from the CDC website.
100% -
90% -
80% -
• 70% -
60% -
50% -
40% -
30% -
23%
20% - 17%
10% - _ill__
0%
Jefferson County* Washington State
County rate is significantly lower(better)than the state rate.
11111
4/16/02
Figure 3. At risk for health problems related to physical inactivity?
• (No physical activity or<3 times/week, 20 minutes day)
Jefferson County and Washington State 2001 BRFSS
Jefferson County* 13%
Washington State 27%
Figure 3. At risk for health problems related to
physical inactivity? Jefferson County 2001 and
Washington State 2000 BRFSS
Source: Jefferson County Department of Health&Human Services,2001 BRFSS;Washington
State data from the CDC website.
100%
90% -
80% -
• 70% -
60% -
50% -
40% -
30% - 27%
20% -
13%
10% 1111W__ 111
-
i
0%
Jefferson County* Washington State
County rate is significantly lower(better)than the state rate.
•
4/1 6/02
Figure 2. At risk for health problems related to being overweight?
• (NHANES definition,BMI >=27.8 for males, >=27.3 for females)
Jefferson County and Washington State 2001 BRFSS
Jefferson County* 29%
Washington State 36%
Figure 2. At risk for health problems related to
being overweight? Jefferson County and
Washington State 2001 BRFSS
Source: Jefferson County Department of Health&Human Services,2001 BRFSS;Washington
State data from the CDC website.
100% -
0
90/0 -
80% -
• 70% -
60% -
I
50% -
40% - 36%
30% 29%
20% -
10% -
0%
Jefferson County* Washington State
County rate is significantly lower(better)than the state rate.
•
4/16/02
• Figure 1. (Q10x2) Do you smoke everyday, some days, or not at all?
Jefferson County BRFSS, 2001; Kitsap County BRFSS, 1998 and Washington State BRFSS, 2000
Jefferson County* Kitsap County Washington State
Current Smoker 16% 23% 21%
Figure 1 . (Q10x2) Currently Smoke,
Jefferson County BRFSS, 2001 ,
Kitsap County BRFSS, 1998,
and Washington State BRFSS, 1998
Source: Jefferson County Department of Health&Human Services,2001 BRFSS;
Washington data from CDC website;Kitsap data from Bremerton-Kitsap County Health
District,Office of Assessment.
100% -
90% -
• 80% -
70% -
60% -
50% -
40% -
30% -
23% 21%
20% - 16%
10% -
–111-1
0%
Jefferson County* Kitsap County Washington State
County rate is significantly lower(better)than Kitsap and state rates. 1
•
4/16/02
4/16/2002
• Jefferson County 2001 BRFSS
Risk and Predictive Behaviors
In general among county adults, rates of behaviors that predict good health
are higher, and rates of behaviors that predict poor health are lower.
• Cigarette smoking is among the very worst risk-taking behaviors, because it is
associated with so many diseases. Only 16% of Jefferson County adults
smoked cigarettes in 2001, significantly lower (better) than the rates seen in
either Kitsap County (23%) or the state (21%, Figure 1).
. Being overweight puts people at risk for a number of conditions that can
cause poor health. Only 29% of county adults were overweight when body
mass index (the relationship of height and weight) was computed, a rate
significantly lower (better) than the state rate, 36% (Figure 2).
. Being physically inactive (neither engaging in physically demanding work nor
having any leisure time activity or being active fewer than three times a week
for at least 20 minutes/time) is associated with conditions that can cause poor
health. Only 13% of county adults were physically inactive, a rate significantly
• lower (better) than the state rate, 27% (Figure 3).
• Alcohol consumption can be protective: adults who drink an average of 1-2
drinks on most days, moderate drinkers, have lower death rates than those
who abstain. But the highest death rates are among heavy drinkers, those
who consumed five or more drinks at one time in the past 30 days.
Seventeen percent of county adults were heavy drinkers by that standard, a
significantly lower (better) rate than that for the state, 23% (Figure 4).
• The presence of any one risk behavior is associated with threats to good
health. Multiple risks represent even greater threat. We evaluated all
possible combinations of the risks cited above and found
o Among those who currently smoke, 34% reported heavy drinking within
the previous 30 days (Figure 5). This is twice the average prevalence.
o Among those who are overweight, 27% reported heavy drinking within
the previous 30 days (Figure 6). This is almost 60% above the
average prevalence of heavy drinking among all county adults.
o Among people who are overweight, 18% were physically inactive
(Figure 7). This is significantly above the county's average inactivity
• level among adults, 13%.