Take Care, B'more

Show Your Heart Some Love This Month

2012-02-01T12:35:00.000-08:00

Today starts American Heart Month. It’s an annual ritual that reminds us to take stock of our heart health by knowing our numbers, blood pressure, cholesterol and glucose, as well as eating right and exercising.


National Wear Red Day is Friday, Feb. 3.

On my way to a meeting this morning I almost had a fender bender because of reading while driving. No, I wasn’t texting or looking at my GPS. I was horrified by the new billboard on I-83 North. Cute little Suzie Utz is pandering to our comfort food weaknesses when she says, “The way to this city’s heart is through its stomach.” I guess my outrage meter was already a little elevated because I had just seen a television commercial where Dunki n' Donuts is marketing heart-shaped donuts as a way to let our loved ones know how much we care about them.

There are physiologic effects to eating foods high in salt and sugar that include the release of certain “pleasure” hormones _ the same hormones the body releases during sex. The big food conglomerates are fully aware of this, and they bombard us with messages that mislead us into thinking that high fat and calorie foods are synonymous with love. Don’t be misled – this is not the same joy we derive from eating ‘comfort foods’ that remind us of our grandmothers.

If you really love someone, have the courage to take away the potato chips and donuts. Spend time outdoors together enjoying the health benefits that nature has to offer. Talk about supporting each other in living a healthier life.

I don’t believe the long-term picture is as bleak as some would paint it. But Baltimore City Mayor Stephanie Rawlings-Blake was correct earlier today when she said government alone cannot fix the obesity crisis. We all play a role, and it starts with modeling good heart health behaviors for our children.

So what steps will you take this month to improve your heart health? For information about upcoming screenings and quitting smoking, a good place to start is our Website, www.baltimorehealth.org. There you’ll also find a video of the Mayor’s remarks from City Hall today.

Take care, B’more.

Join Us For A Community Meeting, Discussion of Health In Your Neighborhood

2012-01-31T12:55:00.000-08:00

As part of our Neighborhood Health initiative, this evening Baltimore City Health Department will hold its first ever community meeting presenting the 2011 Neighborhood Health Profiles. There will be 13 others, one in each council district, which will follow over the course of the next several weeks.

This event marks a distinct change in direction for the health department. It’s a direction that is more neighborhood-focused. They say all politics is local. The same can be said just as loudly for health. Since the release of Healthy Baltimore 2015 in May of 2011, we have been focusing more on the social determinants of health – things such as transportation, housing, employment and education that together influence community health outcomes to a greater degree than direct medical services. The Profiles paint a picture of health that includes the dimensions of our built environment for each of our neighborhoods. While that in and of itself is more than most large cities have done, it is not enough.

All too often public health data sits in the ethosphere with missed opportunities zipping by. These community meetings signify our intent to create a different way of engaging with communities. It’s the beginning of a process by which we more fully collaborate with communities to identify common areas where we can take action.

The health issues facing many parts of our city, at first glance, can appear overwhelming. A closer inspection, as offered by the Profiles, makes clear that a process of prioritizing and directing broad-based coordinated efforts to targeted areas will be a winning strategy for the city as a whole.

Don’t be a spectator – we all need to have some skin in the game if we’re to realize a Baltimore where all residents realize their full health potential.

Check out our schedule of events and take the first step.

Safe Streets Baltimore: New Study Shows Program Is An Effective Public Health Approach To Reducing Gun Violence

2012-01-11T14:35:00.000-08:00

Over the past ten years, Baltimore has made significant progress reducing violence. Homicide is at its lowest level since 1978, and juvenile homicides and shootings are down nearly 70% from 2001.

The Health Department’s Safe Streets Baltimore initiative is an important component of Mayor Stephanie Rawlings-Blake’s strategy to reduce homicide and shooting rates. Launched in 2007, Safe Streets is an evidence-based, public health initiative that intervenes in crises, mediates disputes between individuals, and intercedes on group disputes to prevent violent events.

Safe Streets currently operates in Cherry Hill and McElderry Park, but today, I joined Mayor Rawlings-Blake in announcing the expansion of this vital program. Safe Streets Baltimore will be expanding to additional communities as a result of a $2.2 million dollar award from the Office of Juvenile Justice and Delinquency Prevention. The funding will also be used to expand the initiative to two additional communities that are disproportionately impacted by violence. Interested community groups can review the RFP at http://baltimorehealth.org/rfp.html.

Our expansion of Safe Streets is supported by the release of a new study today by researchers at the Johns Hopkins Bloomberg School of Public Health demonstrating the program’s effectiveness. As noted in the Robert Wood Johnson Foundation’s New Public Health blog, this study demonstrates clearly that a public health intervention can be a successful means for reducing youth violence. Violence is a learned behavior, and as a learned behavior, it can be prevented using the same methods we use to stop the spread of disease.

Some of the key findings of this study include:

• In all four neighborhoods (McElderry Park, Ellwood Park, Madison-Eastend, and Cherry Hill) the program was associated with a statistically significant decline in either homicides or nonfatal shootings, or both.

• Overall, researchers estimated the program prevented at least 5 homicide incidents and 35 nonfatal shooting incidents.

• In Cherry Hill, the program was associated with a 56 percent decline in homicides and a 34 percent decline in nonfatal shootings.

• The program was associated with a 34 percent drop in nonfatal shootings in Elwood Park.

• Researchers estimated that Safe Streets Baltimore was responsible for a 26 percent reduction in homicides in McElderry Park over the nearly three and a half years the program was in place. This site did not experience a homicide during the first 23 months of program implementation.

I would like to thank those who have invested in Safe Streets and urge local foundations and the business and faith communities to continue to step up and invest in this initiative – which has been proven to save lives.

We can be a safe city, but we must continue to support those programs which are contributing to our success. While the Health Department has been awarded funds for expansion of Safe Streets, additional funding is needed to sustain the existing two sites past this fiscal year. The Health Department will use these positive evaluation results to seek additional funding for Cherry Hill and McElderry Park. I join the Mayor in urging local faith, non-profit, and businesses to lend their support to this vital initiative.

To view the full report on the effectiveness of our Safe Streets program, or for more information or to find out how to apply to become a Safe Streets site, please visit the Health Department’s Website, www.baltimorehealth.org/safestreets.

Take Care, B’more!

Baltimore Declares First Code Blue of the Season

2011-12-07T13:06:00.000-08:00

Because anticipated drop in temperatures and expected snowfall are a potential danger to health, I declared the first Code Blue cold weather alert of the winter season for tonight. The City’s Code Blue is a multi-agency effort to reduce hypothermia deaths this winter by protecting homeless individuals, seniors and other vulnerable populations from extreme cold weather.

In response to the City’s expected freezing temperatures overnight as well as potential snow accumulation, tonight’s code blue declaration will trigger several responses aimed at providing for those must susceptible to extreme cold weather:

The Mayor’s Office of Homeless Services operates a 24-hour Housing & Resource Center for men and women at 620 Fallsway.
Private homeless shelters will be encouraged to extend their hours and keep people indoors.
Homeless Services will provide 60 additional beds for residents seeking meals and sleeping quarters accessible thru the Housing & Resource Center at 620 Fallsway.
Additional cold weather education and outreach efforts, as needed.

Last winter, there were 8 days when the high temperature did not surpass 32 degrees Fahrenheit.

The state Medical Examiner’s office recorded 11 hypothermia-related deaths in Baltimore.

Our city’s most at risk of hypothermia death include the elderly, individuals with pre-existing heart conditions, those who abuse alcohol, drug users and the homeless.

As always, it is important to minimize your risk of hypothermia by staying indoors in safely heated areas. If you must go outside, be sure to dress warmly and stay dry. Also remember that drinking alcohol – even in small quantities – can increase your risk of cold-related injuries, so imbibe with caution. And of course, if you have elderly or chronically ill neighbors, check in on them to make sure they are staying warm.

On this first Cold Blue night of the season, it’s also important to remind residents lacking heat of the dangers of carbon monoxide poisoning from using generators in enclosed spaces, or burns caused by alternate heating sources. Energy assistance is available to residents in need at the Office of Home Energy, 410-396-5555.

If you or someone you know needs shelter tonight, please find the list of city and private shelters on our website. For other cold-related inquiries and service requests, or to find a nearby homeless shelter, residents can call 311 (410-396-3100 after hours).

Bundle up, and take care, B’more.

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Honor National Flu Vaccination Week By Getting Immunized

2011-12-06T08:30:00.000-08:00

Winter is here, and that means a host of wonderful traditions – ice skating, hot chocolate, building snowmen, and the Hampden holiday light show. It also means we are in the midst of flu season. This week is National Flu Vaccination Week (December 4 – 10). If you haven’t already received your annual flu vaccine, I encourage you to get one before it’s too late.

According to CDC, it takes about two weeks after vaccination for antibodies to develop in the body and provide protection against influenza virus infection. Therefore, CDC recommends early vaccination to ensure that as many people as possible are protected during the current flu season. That is why it is so important for people to get vaccinated early in the season.

It is also important to take preventive measures at this time of year: wash your hands frequently, cover your mouth when coughing and sneezing, and stay home when you’re sick. These steps will keep you from spreading or catching the flu this year.

Typical flu symptoms include fever, dry cough, sore throat, runny or stuffy nose, headache and muscle aches, and extreme fatigue. While most people recover quickly and fully from the flu, others are at risk for more serious complications.This includes children under five, adults over 65, pregnant women, and those with certain health problems. Residents in these high risk categories are encouraged to contact their physician as soon as they experience any flu symptoms, especially fever and cough, to find out if they may benefit from anti-viral medications. If taken early in the course of the flu, these medications can help decrease the length of illness. Also, persons over 65 years of age should check with their healthcare provider to make sure they are vaccinated for pneumococcal disease.

If you haven’t gotten your flu shot yet, I encourage you to visit one of the Health Department’s TIKE clinics. Shots are free and there is no appointment necessary. Other tips on avoiding flu are available on the DHMH website at www.dhmh.maryland.gov, and from the CDC website's flu information web pages at http://www.cdc.gov/flu/.

A Major League Win for Tobacco Cessation: MLB Bans Smokeless Tobacco in Games

2011-12-05T12:59:00.000-08:00

Over the summer, I shared with you the initiative among health commissioners from 15 major US cities – including Baltimore – to urge Major League Baseball to curb tobacco use among its players. When MLB announced the terms of the players’ new contract recently, we received extraordinarily good news: the new bargaining agreement includes historic limitations on the use of smokeless tobacco by players, managers and coaches.

The new agreement prohibits players, managers and coaches from using smokeless tobacco during televised interviews, at team events, autograph signings and other appearances made on behalf of their teams. Any time when fans are in the ballpark, they will be prohibited from carrying tobacco products in their uniforms or on their body, and violators are subject to discipline.

Major League Baseball and the players’ union are jointly launching a nationwide public service campaign against smokeless tobacco, with youth – and in particular, young baseball players – as the target audiences. The Major League Baseball Players Association is establishing its own Tobacco Cessation Center, to be launched in the 2012 season. In addition, players will be screened for oral cancer during their annual physicals, probably at spring training.

This is extraordinary news, because the simple fact of the matter is that tobacco use is the number one cause of preventable death in the United States. As cigarette smoking has declined, the tobacco industry has increased its marketing of smokeless products and is spending record sums to promote them. But smokeless tobacco use is itself very dangerous, causing serious diseases of the mouth, including oral cancer. In addition, there is reason to worry that smokeless tobacco use by young persons may serve as a gateway to cigarette smoking, this nation’s leading preventable cause of premature death and disease. The new contract means that players, coaches, and managers will be offered the resources to quit and the screenings they need.

To show they are tobacco-free, many players turn their pockets inside out. That trend was pioneered by former Baltimore Oriole Tony Batista. Come Opening Day next year, I hope to see a whole lot more inside-out pockets on display.

While these provisions do not include an outright prohibition on smokeless tobacco use during games, they represent the first steps baseball ever has taken to begin breaking the game’s addiction to tobacco. The new agreement will make a difference in how smokeless tobacco is perceived by young people, and hopefully represents a major step toward its ultimate elimination from the game.

To show your appreciation to MLB for taking this major step toward eliminating tobacco use from America’s greatest pastime, visit Tobacco Free Baseball and sign their online thank you letter. If you are anyone you know wants to quit tobacco, we urge you to call 1-800-QUIT NOW for information on how to stop.

Take care, B’more.

How Baltimore Is "Moving Forward" on HIV/AIDS

2011-11-30T14:49:00.000-08:00

Today we mark a monumental achievement in our ongoing fight against the scourge of HIV/AIDS. For three decades now, HIV has been a long-standing and significant health problem in Baltimore, with terrible consequences. Countless people from all walks of life have died from HIV/AIDS. More than 13,000 people—two percent of the City’s population—are living with HIV.

In addition to the physical and emotional tolls the virus takes on its victims, the costs to our society are staggering. Everyone reading this, I’m sure, has been touched by this epidemic in some form or fashion. Through various programs and initiatives—the City has made tremendous progress in getting more people tested for HIV, getting more HIV positive people into care, and helping those with HIV live longer, healthier lives.

Now, on the eve of World AIDS Day, I’m pleased to report Baltimore has a new, aggressive plan to dramatically reduce new HIV infections, expand treatment, better coordinate services and make a significant improvement to the status of the HIV/AIDS crisis in Baltimore. On Tuesday, Mayor Stephanie Rawlings-Blake unveiled our new strategic report on HIV, “Moving Forward”. The strategy will help us better engage non-profit and community partners in our efforts educate residents and improve the lives of those who are HIV-positive.

The report was prepared by the Baltimore City Commission on HIV/AIDS. It adopts specific, measurable goals in four key areas and outlines a variety of strategic initiatives to achieve those goals in an accelerated timeframe.

1. Reduce new HIV infections by 25% in Baltimore City by 2015

2. Increase access and improve health outcomes by facilitating earlier, more continuous, and more comprehensive care

3. Reduce HIV-related health disparities by focusing resources and coordinated services on the most at-risk populations

4. Achieve a more collaborative City response by creating effective linkages between services providers, advocacy organizations, and community-based models

The measurable goals and specific strategic initiatives outlined for each of the key goals are designed to drive aggressive and fundamental changes, yet are calibrated to be realistically achievable by 2015. I’m especially pleased that our vision aligns with the new National HIV/AIDS Strategy, as well as the ambitious goals we’ve set for improving the health of Baltimore residents through our Healthy Baltimore 2015 agenda.

Reducing HIV disparities is of particular concern in Baltimore. Eighty-seven percent of new HIV infections are among African-Americans, who only represent 64% of Baltimore’s population. This is one of the City’s most glaring health disparities. As referenced in the Strategy, 44 percent of the city population from 10 zip codes represented 60% of new HIV cases. These same zip codes have high rates of STDs, poverty and crime, along with higher rates of other poverty-related health problems, like cardiovascular disease and diabetes.

The Health Department, working in concert with our partners at the state and in the community, is working hard to address these needs. We provided more than 45,000 HIV tests in calendar year 2010. Through these efforts we identified 283 people who were previously unaware of their positive HIV status. Additionally, we operate two STD clinics that provide in excess of 30,000 patient visits per year, and offer HIV testing to all patients who register. Lastly, we are preparing a social marketing campaign in collaboration with Maryland Institute College of Art aimed at increasing awareness and testing among African-American MSM, the group that is currently experiencing the highest rate of HIV transmission.

Our focus is to ensure that patients who test positive make it all the way from receiving their results, through notification of their sex and needle-sharing partners, to being linked to HIV primary care. As leaders of these efforts, we have a responsibility to hold ourselves and each other accountable to achieving measurable results

It is important to realize that the report provides critical guidelines for dramatically reducing HIV/AIDS in Baltimore, but reaching the target goals that have been established cannot be achieved unless communities and individuals also make effective prevention and treatment of HIV/AIDS a priority.

This strategy is our path forward. I’m counting on all of you to help us put this strategy into action. Let’s show the world that Baltimore is aware, that Baltimore cares, and that Baltimore is committed to stopping the spread of HIV.

Maryland Highlights New Family Planning Works Act

2011-11-22T13:12:00.001-08:00

Like many other bills passed this spring by the General Assembly, the Family Planning Works Act received little fanfare at the time. But come Jan. 1, this important piece of legislation will provide free family planning services for 35,000 additional low-income women in Maryland.

Passage of the Family Planning Works Act is an important step in Baltimore’s ongoing efforts to improve birth outcomes by reducing a stubbornly high teen pregnancy rate and the number of unintended and unplanned pregnancies. Approximately 1 in 6 of all births in Baltimore occurs to teen mothers. Our teen pregnancy rate of 64/1,000 is twice that of the state and almost twice that of the United States. Far too many of these teen births are unintended. Our teenagers need better access to pregnancy prevention information, resources and support networks.

Maryland ranks near the bottom nationally in its rates of infant mortality and other birth outcomes measures, and Baltimore City, Prince George’s County, and the Eastern Shore have the most critical women and infant health needs in the state. This expansion will improve birth outcomes by reversing infant mortality and low birth weight rates, improving the health of mothers and babies, and reducing the number of abortions. Additionally, the reduction in unintended pregnancies and births is expected to produce $20 million to $40 million in savings for the state.

This move has public support. According to a survey by The National Women's Law Center and Planned Parenthood Federation of America, 76% of voters strongly support efforts to reduce the number of unintended pregnancies in America through common-sense measures such as comprehensive sex education and access to contraception.

The Family Planning Works Act will help women of all ages—especially many teens living in Baltimore City—with the access they need to obtain the safest and most effective forms of birth control…for free.

Women can sign up immediately, and free family planning services – including breast and reproductive cancer screenings, pelvic exams, sexually transmitted disease testing, pregnancy counseling, and contraception – will be available beginning on January 1st. The Act allows all women up to 200% of the Federal Poverty Level – about $22,000 per year for a single woman – to receive free family planning services.

I urge women to sign up now so they can start receiving services on January 1^st when the new law takes effect. If you are a working woman who could not qualify for coverage before, I encourage you to call 311 to get connected to one of our clinics today. If you are a teen thinking about engaging in sexual activity, or if you are having unprotected sex—call 311 and get connected to learn about birth control counseling options.

This service is free. It and will improve your health, and the health of your family.

This expansion is very positive news for Baltimore. By helping more of our teens and young women better plan for their future and the future of their families, we can positively impact health outcomes citywide.

Social Determinants of Health Indicators Make It To Healthy People 2020

2011-11-08T06:08:00.000-08:00

Last week, I attended a lecture from a national leader in public health who, when asked about the most powerful strategy to address the root causes of poor population health, suggested investment in early childhood education. This expert’s advice speaks to what the evidence tells us about the impact of education on longer life expectancy, improved health, greater quality of life, and more health-promoting behaviors. But this thinking confirms what community members have long known, that where we live, work, learn, and play dramatically impacts our health.

Our city-wide policy agenda, Healthy Baltimore 2015 incorporates the “social determinants of health” with other leading indicators prioritized based on where we can have the greatest impact on morbidity and mortality, and improve the quality of life for city residents. But, of course, our community health improvement efforts exist within a larger state and federal context. For that reason, I was thrilled to see that our thinking in Baltimore is consistent with the 12 national priority indicators of health, announced yesterday by the Department of Health and Human Services.

Like Healthy Baltimore 2015’s 10 priority areas, the 12 national priorities include a focus on the root causes of poor health in addition to traditional public health and health care access indicators. Both sets of priorities include an intention focus on identifying and reducing health inequities. Also similar, the national priority areas incorporate what we know about critical points across the life cycle where interventions are likely to have the greatest impact on health outcomes. One major difference between the national and local priority areas is that in Baltimore, we emphasize the importance of place. For example, priority area 10 focuses on the need to “create health promoting neighborhoods” with a specific focus on liquor outlet density and vacant housing which are both significant concerns for many of our neighborhoods.

It is an exciting time to work in public health, with alignment between the national Healthy People 2020 initiative, Maryland’s State Health Improvement Plan, and Healthy Baltimore 2015. I believe we have an unprecedented opportunity to improve health in our city as a whole and reduce long standing health inequities. I encourage you to check out the 10 national priority areas as well as the Healthy Baltimore 2015 priority areas and to join with us in this city wide effort to improve population health.

How will you Script Your Future?

2011-11-04T14:33:00.000-07:00

Earlier this week, I had the privilege of welcoming U.S. Surgeon General Dr. Regina Benjamin to Baltimore City’s Inner Harbor. The occasion was a press conference to announce Baltimore is one of several cities selected to participate in the multi-year national Script Your Future campaign.

While most Americans recognize the importance of taking prescribed medication as directed, people who skip or forget doses are less likely to understand the health consequences of medication non-adherence. Poor medication adherence has serious health consequences can impact patients’ quality of life and longevity, especially those who suffer from chronic conditions such as asthma, high blood pressure and diabetes. Script Your Future aims to educate consumers and health care professionals about this danger.


Dr. Barbot poses US Surgeon General Dr. Regina Benjamin.

It starts with a better understanding and awareness of the problem. There are many barriers and predictors of non-adherence. Nearly three out of four Americans admit that they do not always take their medication as directed, a problem that causes more than one-third of medicine-related hospitalizations, nearly 125,000 deaths in the United States each year, and adds $290 billion in avoidable costs to the health care system annually.

One thing is clear – if we want more patients to take their medicine as directed, we need to get health care professionals and patients to talk to one another. Research shows that many patients with chronic conditions often have a poor understanding of their condition, how their prescribed medication works and the consequences of not taking it. And doctors and pharmacists often aren’t aware if their patients are taking their medicine or not.

When patients understand their condition and how medication helps them manage it, they are more likely to commit to taking their medicine. But that commitment needs to be a two-way street. Right now, conversations between patients and health care professionals aren’t happening nearly as often as they should. It’s often hard to find the time to have these conversations and, sadly, physicians are rarely taught how to best motivate patients to take their medicine as directed. But we have to take the time.

It really does start with a conversation.

I’m excited to be a part of the Script Your Future campaign in Baltimore because it provides tools and resources to help health care professionals and patients talk to each other, and it aids us in our mission for Healthy Baltimore 2015. One of our goals is to increase by 10 percent the number of adults with high blood pressure taking medications. Currently, only three out of four adult men diagnosed with high blood pressure report they are taking medicine for high blood pressure. Script Your Future contains many useful tools that can help our physicians, nurse practitioners and pharmacists be more effective in communicating with their patients and help their patients avoid the serious health consequences of not taking medication as directed.

To see a video of the press conference from WMAR Ch. 2 news, click here.

What have been some of the barriers you’ve had to overcome to take your medicines as prescribed? Do you use a pillbox? Do you keep a list of medicines with you at all times? I’m curious to hear your thoughts on the campaign and subject.

Take Care, B’more!

The scary truth about Halloween candy, calories and kids

2011-10-31T11:23:00.000-07:00

This Halloween, the vampires, ghosts, and Disney princesses that stop by your door clamoring for treats will be gathering a scary amount of candy – with public health specialists estimating that kids will bring home up to 7,000 calories worth of loot after trick or treating this year. To put that into perspective, you could eat 29 pounds of green grapes and consume the same amount of calories. This is truly frightening news when you consider the growing obesity epidemic facing our kids, as well as the heart health and diabetes risks associated with high-fat, HFC-laden Halloween treats.

The funny thing is that while Halloween candy is shrinking, we seem to be eating more of it, one individually-wrapped bite at a time. Studies show that when products are put into smaller packages and there are many of those small packages available, people eat significantly more than if they were presented with multiple full-sized candies. So that bag of fun-sized Snickers on your desk is probably worse for you than a case of full-sized candy bars.

If you’re still in doubt about what candy might be the safest bet if you’re watching your sodium or sugar intake, the Huffington Post lets you test your knowledge of Halloween nutrition (or lack thereof). You can also check out FitSugar’s 100-calorie gallery to help you pick a healthy portion when you do decide to indulge.

In light of some of these terrifying nutritional facts, consider handing out something a little healthier to the tricksters this year. Apples are a classic choice for the health-conscious neighbor; pretzels, baked potato chips, and raisins are other healthy treats. You could encourage the little goblins’ creative side by handing out small tubs of Play-Do or other craft supplies. In fact, there are tons of non-food options to hand out – temporary tattoos, bubbles, crayons, bouncy balls, and stickers . . . the list goes on.

Another tip for parents I like: set a limit for how many pieces of candy children can eat each day _ and stick to it.

The good news? No matter what you’re handing out, trick or treating door-to-door means a lot of walking, which can help burn off some of that candy corn.

If you’re concerned about the safety of the candy your children bring home, be sure to check out our Halloween candy safety tips on our Website homepage.

Trick or treat with care, B’more!

Is our healthcare system to big to fail? Thoughts from the APHA annual meeting

2011-10-31T10:49:00.000-07:00

Yesterday the annual meeting of the American Public Health Association (APHA) in Washington, D.C., began in earnest. This is the time of the year that public health practitioners from all over the country gather to learn about what’s been accomplished over the previous year as well as what’s hot.

In reviewing the program, it’s clear that across the country much has been accomplished. What's also apparent is that public health has never been more important.

The United States spends more money on healthcare than any other country and our health outcomes are amongst the worst of the world’s developed countries. If the U.S. healthcare system was a stand-alone business, we would have been outsourced to Europe or Costa Rica. The truth is that our healthcare system is too big to fail for many reasons, but mostly because the health of our nation is central to our ongoing competitiveness in the world market.

The role of public health has never been more important. Chronic diseases are what are killing us. The medical system has not been able to make significant inroads into turning this tide because our healthcare system was not built to promote health; it was built to treat illness. As such, it doesn’t have the capacity to meaningfully identify, let alone address, the social determinants of health _ examples are unhealthy housing or inadequate public transportation systems _ that perpetuate poor health outcomes.

Health reform and the Affordable Healthcare Act offer an opportunity to truly transform how this country promotes health. It’s up to us in public health to seize the opportunity to improve the health of our communities.

To learn more about the conference and what’s hot, follow along on APHA’s Annual Meeting Blog.

I am excited to be here and learn from my colleagues from around the country about what’s worked and what hasn't in their communities to improve health outcomes. I look forward to returning to Baltimore invigorated and armed with many new ideas for promoting better health for all.

Take Care, B’more.

Don't gamble with your health - get a flu shot soon

2011-10-27T14:23:00.000-07:00

If you were playing poker, calculated the odds and knew you had a 60 percent chance of winning the pot, would you make the call or fold?

Americans face a similar decision each autumn: whether or not to get vaccinated for the flu, or fold and hope not to get sick. Unlike the common cold, influenza is a serious viral illness. This week, we learned a little more about the odds that a flu shot or flu mist will protect those who receive it from the influenza viruses currently circulating.

Based on a review of selected, previously published studies, authors of the recent The Lancet Infectious Diseases article reported the flu shot was 59 percent effective against flu in healthy adults. This finding may be a surprise to some. But effectiveness ranges widely from season to season and can also vary depending on the health and age of the person being vaccinated.

This is why public health leaders, the federal government and industry are investing and supporting the development of new and improved influenza vaccines. Maximizing our protection against influenza also requires diligent attention to frequent hand washing and covering our mouths when we cough or sneeze. It’s all of these things to together that increase our odds of not getting influenza.

But the fact remains: vaccination is still the safest, most effective means for preventing transmission of the influenza virus and staying healthy. This is especially important for the very young, elderly and people with high-risk chronic health conditions. Scientific observational studies have demonstrated the value of influenza vaccines in this population time and again. And as this Time magazine piece notes, "59% is better than zero."

This flu season, don’t gamble with your health. Make the call and get protected from influenza by getting the flu shot or flu mist at your doctor’s office, local pharmacy, or dial 311 to find the nearest Health Department free clinic.

Take Care, Baltimore

Baltimore City Health Department Releases First Latino Health Report

2011-10-21T13:59:00.000-07:00

As the Health Department works to reduce disparities and improve the health of all Baltimoreans, it is important for us to have a solid understanding of the strengths and health challenges faced by particular groups. As the fastest growing segment of our city, Latino Baltimoreans are one population whose health status we must examine more closely. To this end, we have released the first ever examination of the health status and trends among Baltimore’s Latino residents.

In general, Baltimore’s Latino population is ethnically diverse and relatively young (median age is 27 years, compared to 35 for Baltimore overall). The report revealed some encouraging news about the status of this group, who were found to have lower overall mortality and infant mortality rates. It also revealed that fewer Latinos are smokers – 16 percent of adults, compared to 28 percent of all Baltimoreans.

However, Latinos in Baltimore still face a number of significant health challenges, including lack of health insurance and medical homes, high incidence of binge alcohol drinking, and death by accident - which is the third leading cause of death among this group.

The report was released yesterday during an event held at Baltimore Medical System’s Highlandtown Healthy Living Center, which sits in one of the largest Latino communities in Baltimore. BMS has served between 8,500 and 9,000 patients for whom English isn’t their first language. They employ bilingual physicians and other staff, many of whom also have multi-cultural backgrounds that help them understand the needs of patients from other countries. For Baltimore's growing refugee population, BMS also provides foreign language interpretation for initial health screenings and ongoing medical care.

As one of the largest providers of health care to the Latino community, Baltimore Medical System has long recognized the importance of providing culturally appropriate healthcare and language access services. President & CEO Jay Wolvovsky supports their mission to provide healthcare to all residents of the community – especially the underserved. Over the years, the demographics in Baltimore City have changed dramatically, and BMS has changed with them. Today, 25% of their staff is bilingual, and they offer many services that help patients overcome barriers to care.

I would like to thank Baltimore Medical Systems for their strong support of Latino healthcare in Baltimore and their partnership in the release of The Health of Latinos in Baltimore City.

For the first time, we see how Latinos living in Baltimore City compare to city residents as a whole, and Latinos statewide and nationwide. In bringing together data about Latino health, this report can serve as a tool for public health efforts to advance the health of the Baltimore City Latino community. It’s my hope that this report also will spark conversations about setting priorities for action and new ideas for change.

Check out the full report, available in English and Spanish, on our Website. And here are links to media coverage of the release in the Baltimore Sun newspaper and WJZ TV.

BCHD’s Healthy Homes Bureau receives $100,000 EPA Grant

2011-10-18T13:07:00.001-07:00

In urban centers such as Baltimore, environmental conditions that can lead to poor health for our children are widespread. These include lead due to peeling paint, mold, pests and pesticides, carbon monoxide, and tobacco smoke.

Here in Baltimore, we understand that we must work collaboratively to build stronger, healthier neighborhoods and schools for our children—places where our children can learn and thrive.

Today I joined Mayor Stephanie Rawlings-Blake, Environmental Protection Agency Administrator Shawn Garvin, and Congressman John Sarbanes to celebrate Children’s Health Month and to accept a $100,000 grant to fund the Healthy Environments for City Kids Initiative. Healthy Environments for City Kids (HECK) will help us improve child health outcomes by addressing a wide variety of environmental risks in the places children spend most of their time – at home, in school, and in childcare.

BCHD was one of 13 organizations selected from 263 applicants across the country to receive a grant from EPA’s Office of Children’s Health Protection to reduce children’s exposures to environmental hazards. The Health Department will receive funds over 18 months to promote and support healthy childcare and school environments - places where our children learn and play – to make them safer and healthier.

This grant will enable us to build the capacity of community-based partners – our home visitors, school staff, and childcare providers – to recognize and address environmental hazards. We will engage city residents through innovative strategies such as community-based Healthy Homes meetings, where they will obtain the knowledge and tools needed to reduce environmental health risks in their own homes. By doing so, we are empowering Baltimore city families to take control of their own health, and the health of their communities.

The work neatly dovetails with our Healthy Baltimore 2015 goals to promote children’s health, and create healthy and growing neighborhoods. We know that healthy children learn better, so it makes sense to ensure that the environments in which children live support their health. We are grateful for the support of the EPA and excited to join their efforts to promote healthy environments for our children.

Baltimore's Seniors Strutt Their Stuff For Healthy City Days

2011-10-06T12:45:00.000-07:00

What a week it's been! On Monday Mayor Stephanie Rawlings-Blake and I kicked off Healthy City Days with a walk from City Hall to the Inner Harbor. This week has been jam-packed with health fairs, exercise activities and health screenings, all aimed at encouraging people of all ages to step out and get active, to get screened for serious health concerns, get a flu shot, and get educated about individual health.

All week I've been looking forward to today's signature event: Baltimore's Seniors Rock the City. More than 300 seniors from across the city descended upon the Roosevelt Park Recreation Center in Hampden for a day full of activities. The highlight was the large group circle dance led by former Ravens cheerleader and fitness enthusiast Molly Shattuck of Vibrant Living.

The seniors I talked to really enjoyed getting out in the beautiful weather and, in the words of one of our speakers, "shaking what God gave you." Many received flu shots and were screened for high cholesterol. We are fortunate in Baltimore City to have 16 vibrant senior centers where our elder population can go to socialize, engage in group exercise and other fun activities.

It's important that seniors stay active is by engaging in a variety of activities such as walking, dancing, low or moderate aerobics, swimming, _ even shopping. Half an hour of moderate physical activity every day is a good goal to have. You can start at your own pace and slowly increase your activity until you are able to do 30 minutes of physical activity five days a week; which is 150 minutes of physical activity.

Tomorrow we wrap up Healthy City Days at Mondawmin Mall from 11:30 a.m. to 1:30 p.m. with a free health fair and health screenings. Please tell your family and friends so that they too can participate in health education and screenings. I hope this week you were inspired to think about how you can live a healthy life. I know I'm already looking forward to Healthy City Days 2012. What ideas do you have for activities we can incorporate into next year's agenda?

BCHD Unveils “Just Hold Off” Campaign to Protect Pregnant Women, Infants From Second-Hand Smoke

2011-10-06T12:20:00.000-07:00

Last night at the National Aquarium, as the sun was setting over the Inner Harbor, I joined our B’more for Healthy Babies partners in celebrating Baltimore’s infants and remembering the babies who died before their first birthday. We also unveiled the second phase of our campaign aimed at improving the health of pregnant women. The first leg of this multi-pronged approach will focus on tobacco use, helping pregnant women quit smoking and reducing their exposure to second-hand smoke.

Medical research here is clear: Cigarette smoke is associated with higher rates of Sudden Infant Death. Babies born to mothers who smoke are more likely to be born underweight and premature, two of the leading risk factors for infant mortality.

We want to ensure that pregnant women do not smoke and that pregnant moms and babies live smoke-free in all environments, including in the home, in the car, and everywhere in our communities. This phase is a natural extension of our previous message: Every baby should sleep Alone, on their Back, and in a Crib, and in a tobacco free environment. Our message has also been adopted by the State in its efforts to reduce sleep-related deaths. Recently we expanded the messaging to include fathers, who play a critical role in protecting their babies from unsafe sleep conditions.

As I have mentioned here before, Baltimore’s infant mortality rate declined in 2010. Safe Sleep deaths in particular saw a marked decrease. We are cautiously optimistic the systems and policy changes we’ve supported through B’more for Healthy Babies are having an impact.

One way we are attacking this problem is by improving the knowledge, attitudes, and behaviors that increase women’s risk of poor birth and infant health outcomes. Through community-based activities and mass media messages, we are promoting a safe sleep environment for infants and educating residents on the use of tobacco and exposure to second-hand smoke, particularly among pregnant women, women who have recently given birth and infants.

I hope the message is delivered loud and clear: Baltimore is determined to do everything it can to reduce – and eliminate – infant deaths. In our new advertising campaign, we are asking people to commit to “Just Hold Off” from smoking if they are around pregnant women and infants. Starting this week, our new ads will be displayed on buses, in bus stops and subway stations, and on billboards all over town.

Hold off at home. Hold off in the car or at the bus stop. This simple act of courtesy, repeated a hundred or thousand times over, can have a huge impact on preventing sudden infant death.

We all share a responsibility to protect our city’s pregnant women and infants. As the B’more for Healthy Baby tag line states, “Every baby counts on you.” Today I hope you’ll ask yourself: What can I do to help the next generation of Baltimore babies be born healthy, to a healthy mother in a healthy environment?

Remember, just hold off, and take care, B’more.

Should Maryland Be The First State To Ban Crib Bumper Pads?

2011-09-28T06:40:00.000-07:00

Yesterday morning I was pleased to join Maryland Department of Health and Mental Hygiene (DHMH) Secretary Dr. Joshua Sharfstein and other key public health leaders as he announced a proposal to ban the sale of crib bumper pads starting in January 2013. If approved following a public comment period, Maryland would become the first state to ban the sale of crib bumper pads.

A 2010 report by the Consumer Product Safety Commission found 28 baby deaths involving bumper pads. These are highly preventable deaths.

As the Secretary noted, this action is not happening in a vacuum. The proposed ban is part of a broader effort to promote safe sleep for infants by encouraging the ABCs: Babies should sleep Alone, on their Backs, and in a Crib.

The proposal is the end result of a thoughtful study by an expert advisory panel. After conducting several public meetings, hearing from product manufacturers and reviewing the available safety evidence, the panel concluded “infant bumper pads posed a rare, real risk to infants.”

I applaud Dr. Sharfstein for his leadership on this issue, which establishes Maryland as a trailblazer for infant health and safety. In the last year, Maryland and Baltimore City have made tremendous gains in reducing the rate of infant mortality. We don’t yet fully understand the reason for the improvements we are seeing. But I believe the systems and policy changes we’ve supported through the B’more for Healthy Babies campaign are having a significant impact.

This public awareness campaign has educated countless individuals about how to put babies to sleep safely – Alone, on their Backs, in a Crib, no exceptions. The first component – Alone – means just that. We discourage parents from sleeping with their babies. And cribs should be free of all pillows, toys or blankets and bumper padding.

As part of our basic message to parents and caretakers, our home visiting nurses look for _ and routinely discourage _ the use of crib bumpers. We’ve reinforced this message in our print materials and in our educational video, where babies are pictured sleeping Alone, on their Backs and in Cribs with no extra padding.

Baltimore City's current and last two health commissioners.

The Consumer Product Safety Commission is conducting a similar review. The manufacturing of infant cribs is highly regulated to prevent children from strangling. Because their bodies can slip through openings but their heads cannot, parts such as slats, spindles, corner posts and rods cannot be more than 2 and 3/8 inches apart at any point, according to its Website.

The risk of putting babies to sleep in a crib where they could potentially suffocate against or get entrapped in a bumper far outweighs the purported safety benefits. For these reasons, I support Maryland’s efforts to ban crib bumper pads, and I encourage you to educate others about the potential dangers these products can pose.

Healthy City Days To Start Sept. 30th

2011-09-20T12:43:00.000-07:00

The Health Department, in partnership with the Mayor’s Office, is focused on making Baltimore a healthier city. One major way we are working toward that goal is through the implementation of Healthy Baltimore 2015. Another way we are making Baltimore a healthier city is through initiatives like Healthy City Days.

Photos by Kevin Kane, CareFirst BlueCross BlueShield

Today at the Zeta Center for Healthy and Active Aging, I joined representatives from CareFirst BlueCross BlueShield and the University of Maryland Medical Center, Baltimore Ravens fullback Vonta Leach, Molly Shattuck and others to announce that beginning September 30^th, we will kickoff Baltimore’s 2^nd annual Healthy City Days. Healthy City Days encompasses eight days of events all over town. The purpose is to get people eating better, exercising more often and focused on prevention and overall wellness.

There will be health fairs with free screenings at University of Maryland, City Hall and several Enoch Pratt library locations. There will also be free screenings at Mondawmin Mall, Department of Social Services locations and many other locations. We’ll even have great family events over the weekend at Port Discovery and other Inner Harbor events.

And during the week there are some great events planned that will get people up and moving. Mayor Stephanie Rawlings-Blake and I will be walking from City Hall to the Inner Harbor on October 3rd and working out downtown with Monte Sanders on October 4^th. She and I would love for people to step out of their offices for a few minutes and join us at both of these events.

Vonta and Molly led seniors in a dance and stretch routine.

Personally, I am really looking forward to joining Molly Shattuck and Baltimore’s lively seniors in Hampden on October 6^th for a rockin’ dance party.

All you need to do is visit the Healthy City Days Website to see a listing of all these events and more and find one close to you.

It’s my sincere hope that this interactive initiative will engage Baltimore City residents and workers to focus on healthy lifestyle choices and preventive care.

Which Healthy City Days events do you plan to attend?

Baltimore Sees Reduction in Infant Mortality

2011-08-25T07:41:00.001-07:00

Yesterday, I had the privilege of joining Governor Martin O’Malley, Lt. Governor Anthony Brown, DHMH Secretary Dr. Joshua Sharfstein, Baltimore City Mayor Stephanie Rawlings-Blake, and our community partners at the University of Maryland School of Social Work for an important announcement regarding infant mortality in Baltimore City.

Baltimore has struggled for years with high rates of infant mortality, and the reality is that this rate had been growing. I am pleased to report that last year, infant mortality dropped by 19 percent in Baltimore City. Of this, there was a 40% reduction in infant sleep related deaths in Baltimore. Eleven fewer babies died from sleep-related causes as compared to the previous year. While that number may not sound big, it means the world to families affected by these preventable deaths.

There are some who would argue that this reduction is due to a statistical cycle and does not reflect outcomes due to a particular intervention. While we are cautiously optimistic that that is not the case, we are confident that these numbers are going in the right direction and that our ongoing efforts will continue to drive down the curve and reduce racially-based disparities.

Two years ago, the Health Department, together with the Family League of Baltimore City, charted a course forward through the B’more for Healthy Babies campaign using data we collect about all infant deaths. This campaign, which has 3 phases, is providing education and outreach to mothers, fathers, grandparents and other caregivers to make sure they know the safest way to take care of babies.

Last year the Mayor helped launch the first phase of the campaign by issuing a safe sleep proclamation: Healthy Parenting. Through our community partnerships, our Sleep Safe video is being shown in all eight of the city birthing hospitals, in the jury assembly room, and at intake at the Eager Street prison. These are non-traditional ways of delivering life saving public-health messages. Additionally, we have trained over 1,600 service providers, including DSS workers, community care givers, and health professionals in the ABC’s of safe sleep.

In the next few months we will launch the second phase of the B’More for Healthy Babies campaign. The focus will include family planning, early entry into prenatal care, and smoking cessation. The third and final phase will focus on the importance of good health on a person’s ability to lead life to the fullest and to have healthy babies.

It’s so important for parents to be educated about how to take care of their newborns. That begins with pregnant women and mothers taking care of themselves – by eating healthy and not smoking or drinking. Fathers can also contribute by learning how to put babies down safely. And nobody should smoke around pregnant women and infants; the health risks from second-hand smoke are real.

Today, we’re happy to report progress on one of these important issues, and it’s always good to share some good news. But there’s plenty of work to be done. The fact remains: far too many children under the age of one are dying in our city, and many of these deaths are preventable. Baltimore is determined to do everything it can to reduce – and eliminate – preventable infant deaths. This starts with each one of us acting on what we can contribute. Together we can make a difference.

Health Department Hosts Blood Drive

2011-08-23T09:43:00.001-07:00

As a physician, I am keenly aware of the importance of maintaining a well supplied blood bank. Everyday here in Baltimore and across the world, lives are saved by donated blood. For this reason, donated blood is worth its weight in gold – and then some.

So to waste a single drop is unthinkable.

Recently, Maryland Lt. Gov. Anthony Brown announced the Maryland Blood Wastage Collaborative, an innovative solution for reducing blood waste throughout the state by improving institutional coordination to ensure no blood inventories are allowed to expire. This supports not just individual health, but public health as well.

The Mayor and I encourage our neighborhood leaders to consider hosting a community blood drive and encouraging others to donate through word of mouth, community or church newsletter articles, and other available means.

Today, the Health Department is hosting a blood drive at

1001 E. Fayette Street

from 9 a.m. to 3 p.m. It is open to the public and walk-ins are accepted. If you live or work nearby, I encourage you to stop in and make a donation. Donors will receive a “Be Extraordinary” T-shirt from the Red Cross.

Ultimately, the decision to donate is up to you. Help us help those in need by giving blood.

Meeting People Where They Are: The Needle Exchange Program

2011-08-03T13:52:00.000-07:00

The best outcomes in public health often happen when we meet people where they are.

Our NEP staff - Chris Serio-Chapman, Derrick Hunt and Lamont Clark.

At 10 a.m. this morning, I witnessed a part of life that many of us shy away from. I spent time observing the work Health Department staff do within our harm reduction program. Within the confines of a small camper on a street corner in Southwest Baltimore, two staff members attended to drug injecting users exchanging dirty needles for clean ones. There was a steady stream of clients – men, women, young, old, black and white. Some were regulars who chatted for a bit and then went about their day, while others were in and out in less than five minutes.

One of the clients, a woman just a year older than me, shared she had ongoing liver disease, diabetes and MRSA. She also shared symptoms that made us suspect her diabetes was not under control and we convinced her to follow up with her clinic. Another young lady listed a bunch of STI’s she had been treated for and was concerned she might have HIV. We were testing her for HIV on the spot.

Our Needle Exchange Program (NEP) is the cornerstone of BCHD’s Harm Reduction Program. NEP is an evidenced-based intervention program that provides clean needles to injection drug users in return for used syringes, which are discarded. The purpose of the program is to reduce the frequency of infections passed through the use of unclean needles, infections that include HIV and hepatitis C.

The time I spent on the van gave me a more personal glimpse of the ravages of drug abuse in our city. Our program, run by Chris Serio-Chapman and her staff, is the only confidential needle exchange program in the country. The success of the program has been documented: when the program began in 1994, it is estimated that approximately 650 incident cases of HIV in Baltimore were caused by injection drug use, representing 60.3% of reported HIV. Sixteen years later, the number of new HIV infections caused by injection drug use dropped to 177 new cases per year, representing a 29.5% decrease in the proportion of new HIV diagnoses caused by injection drug use.

One of the many reasons we’ve been successful is the attention paid to doing things that are evidence-based and evaluating the work we do to make sure we’re getting the outcomes that will best improve the lives of the people we serve. An even more important reason is the dedicated staff that we have. In addition to Chris, I got to talk with Derrick Hunt and Lamont Clark about their experience with the program and how we could help people on the road to recovery.

I also had the pleasure of observing the skill with which they were able to engage individual clients by meeting them where they were. NEP has been extremely successful in this regard, currently operating at 17 locations around the city. Since 1994, more than 9 million clean syringes have been distributed to clients, and more than 10 million contaminated needles have been properly destroyed since it was started.

For more information about Baltimore’s needle exchange program, including our location sites and times, please see our website. For the latest NEP updates, be sure to “like” their Facebook page.

Take Care, Baltimore.

Robert Woods Johnson Foundation shines spotlight on Healthy Baltimore 2015

2011-07-14T13:35:00.000-07:00

Today on the Robert Wood Johnson Foundation blog NewPublicHealth, I discuss the foundation's recent county health rankings and the early progress we've made implementing Healthy Baltimore 2015, our health policy agenda for the next five years. If you're new to my blog, you can read more about this exciting initiative here. We will have even more good news on this topic to announce soon. For future updates, please subscribe to this blog.

Code Red Heat Alert In Effect Today, Tomorrow

2011-07-11T11:01:00.000-07:00

Just a quick note to let everyone know a Code Red Heat Alert is in effect today and tomorrow for Baltimore City. The city will open 11 cooling centers where folks can come out of the heat and get a cold drink of water.

Click here to read our full press release and download informational flyers to share with your family, friends, and co-workers about staying safe in the heat. Messages are specific to seniors, caretakers and coaches, among others.

Stay cool Baltimore!

Colorectal cancer screening saves lives

2011-07-06T13:49:00.000-07:00

Good news in our ongoing work to reduce preventable cancer related deaths!

Today the Centers for Disease Control and Prevention (CDC) reported the rate of adults developing and dying from colorectal cancer is falling. Colorectal cancer incidence rates decreased significantly in 35 states over a 4-year period (2003-2007). Maryland realized the largest percentage decrease in incidence (6.5 percent). Mortality due to colorectal cancer dropped 3.1 percent in the state. This is a significant achievement as cancer ranks as the second leading cause of death in our state and in Baltimore City.

Under the auspices of the Maryland Cigarette Restitution Fund Program, the Baltimore City Health Department coordinates local public health efforts for colorectal (CRC) education, prevention, screening and treatment. Emphasis is on increasing the accessibility of health care services to uninsured and medically-underserved residents.

The Baltimore City Health Department and the University of Maryland Medical System receive funds to operate cancer screening programs. The department offers CRC screening and treatment through contractual partners, Johns Hopkins Hospital, Union Memorial Hospital and Harbor Hospital.

Our CRC program targets uninsured and under-insured adults, ages 50-75, who live at or below 250% of the poverty line and have a personal or family history of CRC. In its first year the Baltimore City CPEST (Cancer Prevention, Education, Screening, and Treatment) program has completed 210 colonoscopies.

This report affirms the great progress we are making, but also illustrates that there is still much work to be done. Recognizing the severity of this threat, Healthy Baltimore 2015 includes aggressive goals for encouraging early detection of colorectal cancer .

Those people who should be screened more often for colorectal cancer include:

All adults 50 to 75 years old.
People who are at risk for developing colorectal cancer are those with Crohn's disease, inflammatory bowel disease, some genetic disorders, and people with a personal history of polyps or close family history of either polyps or colorectal cancer. They should talk with a health care provider about getting screened at younger ages and/or more frequently and which test is right for them.

For more information about cancer in Baltimore City and the Health Department’s cancer programs, visit http://baltimorehealth.org/cancer.html.

Clearing the Air: Addressing Asthma Disparities in Maryland

2011-06-28T13:15:00.000-07:00

This morning I had the pleasure of addressing a group of health care professionals at the Asthma and Allergy Foundation’s Clearing the Air: Addressing Asthma Disparities in Maryland conference in Linthicum, Md.

In Baltimore City, over 60,000 adults and nearly 20,000 children have been diagnosed with asthma at some point in their lives. There are considerable disparities in the burden of asthma by age, race, ethnicity, and geography. Young children, African-Americans, those with low income, and urban residents carry a disproportionate burden of asthma in Maryland. Access to quality care is thought to be a significant factor contributing to disparities. Disparate populations may lack insurance, asthma education, or access to quality primary or specialty care providers. These and other barriers to quality care have significant impacts on asthma morbidity and mortality.

One of the key ways that the Health Department is addressing asthma disparities in Baltimore is through Healthy Baltimore 2015, our comprehensive health policy agenda. This agenda aims to explore the root causes that drive health inequities, break down silos between various sectors of our society. To this end we’ve created an interagency task force to examine potential health implications of policy decisions.

To date, the asthma home visiting programs have reached over 500 children and have documented significant reductions in asthma symptoms, roach and mouse infestations, and school absences. Among a sample of 94 clients, 94.7% had a reduction in emergency department visits and 100% had a reduction in hospitalizations after completing three home visits. School-age participants also reported an increased attendance rate.

To address asthma disparities in Baltimore City Schools, we are working with the state to implement the Asthma Friendly School Initiative. More than 30 Baltimore City Schools that are Asthma Friendly. This Initiative requires schools to meet a set of criteria to be considered Asthma Friendly including:

Identifying and tracking students with asthma;
Maximizing asthma management through the use of asthma action plans and case management;
Coordination of asthma management with parents/guardians and health care providers;
Supportive policies regarding access to asthma medication;
Proactive maintenance of buildings and school facilities to reduce asthma triggers and improve indoor and outdoor air quality; and
Asthma education for students and staff

Additionally, the Health Department’s EPA-funded Healthy Environments Healthy Kids program will provide training of and direct services to community-based partners engaged in improving environmental health for children in Baltimore. Through this grant, the BCHD will improve child health outcomes in Baltimore through:

o inspecting and training for city-based Head Start Programs and child care providers focused on environmental and health hazards in those settings;

o training of key home visit staff (e.g., community health workers and nurses, Healthy Start staff) on healthy home fundamentals;

o training for WIC and other community-based partners; and

o integrating healthy homes and community principals into training and certification programs for licensed child care providers.

BCHD will continue to collaborate with its partners to improve asthma disparities, working toward our goal of turning Baltimore into a city where all residents realize their full health potential.

I’m curious to hear what other public health workers are doing around asthma and schools. What are some of your success stories?

Cigarettes Get Graphic New Warning Labels

2011-06-21T13:08:00.000-07:00

Today the FDA announced a major leap forward in the ongoing struggle of educating the public about the dangers of smoking.

Beginning in September 2012, every pack of cigarettes will be required to have a graphic warning label reminding the public about the real life consequences of smoking. Thanks to the Family Smoking Prevention and Tobacco Control Act signed into law in June of 2009, each pack of cigarettes will contain one of the following images:

One of the FDA's new warning labels.

A mouth full of gross teeth with a lip ulcer - early signs of oral cancer
Before and after picture of lungs exposed to smoking
A cute baby about to be engulfed by a cloud of poisonous tobacco smoke
A gentleman smoking through a hole in his throat
An overweight man on oxygen presumably having a heart attack – a consequence of smoking
A cartoon of a premature infant – prematurity a consequence of smoking during pregnancy
A distraught woman next to the caption “WARNING: Tobacco smoke causes fatal lung disease in nonsmokers.”
A corpse with his chest sewn up
A dude proudly sticking his chest out with an “I Quit” logo on his shirt

These images range from the gross to the sentimental to the uplifting. I applaud this effort because we need all the help we can get when it comes to helping people stop smoking.

Cigarettes have been designed to be one of the most efficient ways to deliver one of the most addictive substances on this planet – nicotine. Packaged with slick advertising cigarettes have worked their way to being the number one cause of PREVENTABLE death. Regrettably, I don’t think there’s a graphic for that.

In Baltimore City, smoking rates are as high as they are in states such as Kentucky, one of the highest producers of tobacco plants. There are no safe tobacco products, nor is there a risk-free exposure level for adults, children or pregnant women. Tobacco is a major contributor to early heart attacks, strokes, chronic lung diseases and cancers. There is also compelling evidence of the harmful impact of secondhand smoke to nonsmokers and children who suffer from respiratory infections. Smoking is also associated with preterm births, stillbirths, and low birth weight.

That’s why Healthy Baltimore 2015 identifies tobacco as a priority area for action. Over the course of the coming year, we will collaborate with partners across the city to help our residents stop smoking, or better yet – never start. One of our most important resources is 1-800-QUIT-NOW.

Which graphic do you prefer?

Take Care Baltimore!

National Prevention Strategy mirrors efforts in Baltimore to improve health outcomes, eliminate disparities

2011-06-16T13:08:00.000-07:00

Today I had the pleasure of taking part in a stakeholder panel discussion as part of the release of the National Prevention Strategy. I was representing the National Association of County and City Health Officials (NACCHO), the group that represents the nation’s more than 2,800 local public health departments.
These city, county, metropolitan, district and tribal departments work every day to protect and promote the health and well-being of all people in their communities.

Local health departments are essential to seeing that the strategic directions and priorities of this Strategy result in improved health outcomes. The central role for local health departments will be to do what we do best: Emphasize preventive and quality health care, expand access to care for all populations and engage communities.

In Baltimore City there is a 20 year gap in life expectancy between 2 neighborhoods less than 5 miles apart. Statistics like these give great urgency to the work we do to improve the health of our city, our neighborhoods and our residents. That’s why in April, Mayor Stephanie Rawlings-Blake and I released Healthy Baltimore 2015, an aggressive plan for improving health outcomes and eliminating health disparities.

Healthy Baltimore 2015 highlights 10 priority areas for action that account for the greatest morbidity and mortality in Baltimore City. These priority areas mirror the National Prevention Strategy. Within each of the 10 areas, we identified aggressive benchmarks for improvement because they help to set the level of urgency in addressing ongoing disparities and inequities.

In addition to reporting citywide data for each of the leading indicators, we include the greatest subgroup disparities. In some indicators this is based on race, but in other indicators the greatest disparities are based on gender, educational attainment or income.

Our leading indicators go beyond traditional health measures and explore the root causes that tend to drive health inequities such as access to healthy foods, liquor outlet density and vacant building density.

We’re adopting a health in all policies approach because it’s clear that addressing these long-standing inequities can no longer be accomplished via traditional medical models or even traditional public health models. We’ve convened a cross-agency health task force that has senior level representation from all city agencies.

Our job will be to look at what each agency is currently doing in service of HB2015 and what we can do above and beyond. We’re working with Hopkins School of Public Health to develop evaluation metrics to determine what difference this process makes on the ground.

We’ve also convened a similar group for our clinical providers.

Lastly, we have an innovative private public partnership aimed at reducing disparities in access to healthy foods. It’s our virtual supermarket known as Baltimarket.

The National Prevention Strategy represents an unprecedented commitment by the Obama Administration to the idea that prevention of illness and disease should be a national goal, not just for those of us in the health field, but for every sector of society that touches people’s lives. I stand with other local health departments in applauding federal government leaders represented here today for recognizing that improving the quality of life for all Americans needs to incorporate the influences of where we live, learn, work and play.

Have you had a chance to look at the Strategy? What are your initial thoughts? How can we all work together more efficiently to achieve these goals?

Health Department Testing Reveals Items of Children’s Jewelry With Excess Lead

2011-06-15T10:17:00.000-07:00

Many parents are aware of the health risks associated with lead poisoning. The federal government limits the amount of lead in children’s toys. But what they may not know is our inspectors continue to find some products – especially children’s jewelry – with off-the-charts lead content being sold in Baltimore City retail stores.

Lead is toxic to the nervous system. It can cause severe illness and even death at high doses and cognitive impairment and other neurological problems at lower doses. These health risks are the reason the Baltimore City Health Department tests products for lead levels every month. This morning, we issued violations to three businesses selling items of children’s jewelry that contained dangerous levels of lead. Lead contents below 300 parts per million (ppm) are considered safe. However, these items tested by an independent certified laboratory for as much as 280,000 ppm of lead.

Perhaps the most disturbing aspect of these test results is that one of the products was labeled “lead compliant,” and yet it contained 18,000 ppm of lead – that is 6 times the regulated limit.

All products of the same style and manufacturer to these items are being considered a nuisance to public health. These products may not be offered for retail sale in Baltimore City. Please be on the lookout for these products:

Item: 4pc Pink & Rhinestone Flower Set (Rhinestone flower clip on earrings)

Total Lead Content: 18,000 ppm

Item: Strawberry Charm Bracelet (Big Strawberry Charm)

Total Lead Content: 180,000 ppm

Item: 3 piece Pearl Set (Pearl Necklace)

Total Lead Content: Clasp – 3,800 ppm; Chain – 280,000 ppm

This and other recent toy recalls due to unsafe lead levels should serve as an important reminder for parents to remain vigilant. Dangerous lead levels have recently been found in a Toy Story 3 bowling set, an American Girl’s craft kit, even articles of children’s clothing . In fact, a quick glance at the CPSC’s toy hazard recalls will illustrate that the sale of children’s items containing high levels of lead remains a stubbornly difficult problem to combat.

For more information on Baltimore’s regulation on lead in children’s jewelry, visit our website.

Goodbye Food Pyramid, Hello MyPlate

2011-06-03T11:27:00.000-07:00

First Lady Michelle Obama has been a powerful advocate for ending childhood obesity. Her Let’s Move campaign is aimed at raising a generation of American youth who are healthier and more active than those before them. While her initiatives are directed at kids, Mrs. Obama’s message is an important one for all of us.

We live in a time when two-thirds of Americans are overweight or obese. In Baltimore City, 1 in 3 children is overweight. Additionally, 37% of Baltimore City high school students are overweight, compared to 29% of their counterparts in Maryland.

As we all know, obesity is associated with numerous health problems, including heart disease, stroke, and diabetes. And while sedentary lifestyles play a significant role in the country’s obesity epidemic, so too do poor food choices.

Enter MyPlate. This new tool from the USDA replaces the outdated food pyramid. MyPlate provides a clean visual representation of how our meals should look: half of the plate is fruits and vegetables, with the other half split between grains and protein. Dairy sits in a saucer on the side. This is a far more logical symbol for consumers to make food choices than a pyramid – what could be simpler than a plate?

The old food pyramid primarily instructed consumers to eat a certain number of servings from each food group. However, what constituted a “serving” was not especially easy or convenient for people to figure out. As the First Lady said, "We can't be expected to measure three ounces of chicken or look up a portion size of rice or broccoli." In contrast, MyPlate places a much higher emphasis on portion size and proportion.

It is important to know that MyPlate will not single-handedly end the obesity epidemic – it does not encourage physical activity; explicitly decry slathering vegetables in butter; or address the fact that in many households and restaurants, plates can be the size of small dinner tables. However, news outlets, nutritionists, foodies, and academics agree that MyPlate is a great first step toward educating consumers about smart food choices in a relatable, common-sense way. And just like its predecessor the pyramid, people are encouraged to visit www.choosemyplate.gov for more in-depth information on nutritional food choices.

If we are to meet the aggressive goals we set in Healthy Baltimore 2015 for combating obesity, we must utilize a variety of approaches to educate and change the behavior of our residents. Common-sense tools such as MyPlate can be an important resource for the average family looking to improve their food choices.

What do you think? How does MyPlate compare to the food pyramid? Do you think it will succeed in getting people to eat healthier?

Health Department Observes World No Tobacco Day

2011-05-31T15:08:00.000-07:00

In 2009, the percentage of adult smokers in Baltimore City (28.3%) was higher than Kentucky and West Virginia – the two states tied for the highest percentage of smokers (25.6%) in the country. Although Maryland has one of the lowest smoking rates in the country, significant disparities exist among Baltimore smokers with high and low income and educational attainment levels. The smoking rates for city residents with an income of less than $15,000 is 36 percent (compared to 15.1 percent for the highest income group). Likewise, the rate for college graduates is 14.8 percent, compared to 33.9 percent for those with a high school education or less, according to the 2009 Baltimore City Community Health Survey.

These are troubling numbers, especially because tobacco use remains one of the most preventable causes of death and disease.

Today, I am calling on all city residents to join us in commemorating World No Tobacco Day. This day is an excellent opportunity to raise awareness about the harmful effects of tobacco use on the health and well-being of Baltimore City residents.

The negative health effects of tobacco use are well known. It contributes to early heart attacks, strokes, chronic lung diseases and cancers. There is also compelling evidence of the harmful impact of secondhand smoke to nonsmokers and children who suffer from respiratory infections. Smoking is associated with preterm births, stillbirths and low birth weight, all of which can cause infant mortality. Eighty percent of all fire deaths occur in the home; careless smoking is often to blame.

This year, more than 5 million people worldwide will die from a tobacco-related heart attack, stroke, cancer, lung ailment or other disease. Having killed 100 million people during the 20^th century, tobacco use could kill 1 billion during the 21st century, according to the World Health Organization.

If you or a loved one is ready to take the step of quitting tobacco, we want to help. Every day, the Health Department and our partners provide the following educational outreach and treatment support for tobacco users:

Residents may call 410-361-9765 for a referral to a cessation program.

The Health Department’s SmokeFree Baltimore Tour Bus will provide tobacco use and quitting information from 10:00 a.m. to 2:00 p.m. at Baltimore Medical System at Orleans Square health center at 2323 Orleans St.

The department’s Tobacco Use Prevention and Cessation Program provides pharmacotherapies to Federally Qualified Health Centers (FQHC) for uninsured clients in their cessation programs. Free patches are distributed to clients – either through one-on-one counseling by a health care provider or during cessation classes. To find the FQHC nearest you, call 311, the city’s service line.

The national Quit Line – 1-800-QUITNOW – provides counseling to callers who want to quit. Qualifying callers are provided with a month’s supply of patches and gum.

Being tobacco free is a high priority area for this department. Earlier this month, we unveiled Healthy Baltimore 2015, our five-year health policy agenda for improving health outcomes and reducing health disparities in Baltimore. In it, we set ambitious goals for realizing our goal of a tobacco free Baltimore. I hope you’ll take a few minutes to review this important document and sign up to partner with us on these and other important efforts to improve public health in Baltimore City.

University of Medicine and Dentistry of New Jersey Commencement Speech

2011-05-27T07:59:00.000-07:00

This past Monday, I had the honor of delivering the keynote address at commencement ceremonies for my alma mater, the University of Medicine and Dentistry of New Jersey – New Jersey Medical School. What do you think are the biggest challenges facing the next generation of young physicians and dentists? How can we better bridge primary care and public health?

Dean Johnson, esteemed colleagues, parents and family, and class of 2011.

It is an honor to be your commencement speaker.

It’s astounding to think it was just 20 years ago when I was in your seat. My medical school graduation was one of the most momentous days of my professional career. Personally, I was humbled by the honor of having my grandfather travel from a rural town in Puerto Rico to see his granddaughter become a doctor. As for many of you, this accomplishment was not just my own, it was - and still is - my family’s accomplishment as well. Professionally, I saw it as the beginning of a journey I had always dreamt about. It was real and I had the paper to prove it!

One of my internal motivations has always been hearing my mom’s voice in my head saying “don’t forget where you came from and make sure you give back to the community”. I’m certain that many of you may have that same tape running in your head because we all come from somewhere and we all get to where we are with the support of others. And even if we don’t share similar upbringings, we share the fact that we had the privilege and honor of being from New Jersey Medical School.

Newark, New Jersey and its people have become a part of you - same as you have become a part of the lives you have touched in this city. The patients and families I cared for and learned from here helped to shape my views when I went to Washington, DC to work in a community health center. They also helped to inform my decisions when I went into public health in NYC and now in Baltimore City as health commissioner.

And so MY first point to you is to “remember where you came from and make sure you give back to the community” wherever that community may be.

In preparing for this speech, I searched the internet for just the right quote to impart words of wisdom and I pretty much gave up until I came across a quote that reminded me of what my mom said. It’s a quote from the 18^th century German philosopher, Immanuel Kant:

“Always recognize that human individuals are ends, and do not use them as means to your end.”

By remembering that individuals are ends, we then come to the second point: Each of our patients has something to teach us. All too often this point in medical school has been made within the context of learning about the body and natural course of disease. As you progress in your careers, my hope is that this point will take much greater dimension to learning and integrating how social determinants of health – things that impact where we live, work and play - affect the patients you see and the way you practice medicine.

As physicians we have the privilege of being let into our patients’ lives. Some times by choice and other times in spite of their objections. This privilege should never be taken for granted. With this privilege comes the responsibility of bearing witness to the social conditions that affect individual health outcomes, as well as community health outcomes.

One of the most important things we can do is not ignore the power of the white coat. I encourage each of you to be more than just physicians. I challenge each of you to be physician advocates. To be outraged by the health inequities that are driven by social determinants of health such as education, housing, access to healthy foods and transportation. There are opportunities that will be afforded to you by virtue of the power of the white coat. Use this to the advantage of your patients.

According to the Institute on Medicine as a Profession:

Physician advocacy extends beyond the provision of good clinical care and advocacy on behalf of individual patients to include collaborations with people and organizations that combat interpersonal, structural, and systematic inequities and abuses in our society. Advocacy is the bridge that links patient care with efforts to address social determinants of health, institutionalized prejudices, and structural dislocations that patients and communities face. Physicians are especially qualified to advocate upon behalf of social change. The prestige and credibility that they command may serve as valuable resources in advocacy efforts.

When I was just out of training I worked in a community health center in inner city Washington DC. Day in and day out I saw children that were being lead poisoned by their housing environment. It was frustrating to be treating outcomes that were so easily avoidable. I was at a loss of what to do until I did what we as scientists have been trained to do – document what we see.

I created a very simple database that tracked the addresses of children with elevated lead levels. This simple tool demonstrated that there were identifiable units that were serially poisoning the children of our community. Just as I finished the first phase of the database, I was connected to a young lawyer in the Department of Justice who came to our clinic working on another project, but who was also interested in housing justice.

To make a long story short, he was able to use the database to make his case against delinquent landlords even stronger and levy heavier fines against those landlords. In the end, then-Secretary of Housing Andrew Cuomo came to our clinic to highlight the work that had been done.

The power of the white coat lies in the ability to apply your diagnostic skills to identifying trends in a community. It lies in your ability to translate medical data into everyday language that illustrates that acuity with which things such as housing policy, educational policy and even land use policy affect communities such as the one we have served here in Newark.

As John F. Kennedy said, “the goal of education is the advancement of knowledge and the dissemination of truth”.

Births and deaths and the dignity with which they occur remind us of why it is we do the work we do and that there is urgency to creating a healthcare delivery system that makes healthy choices the default choices.

You will be among the first group of doctors finishing their residency training when the majority of the provisions within the Affordable Care Act go into effect in 2014. None of us know exactly what this beast will end up looking like, but one thing is certain: It won’t be what it is now.

The question is “Will it be what we want it and need it to be?”

Not one of us should have the delusion that an insurance card will be a game changer when it comes to addressing health disparities and health inequities. But we should all have the courage to advocate for a healthcare system that values preventative care, makes it easier for doctors to do the right thing with the use of electronic health records and provides a quality feedback loop at the systems level so that we can know when what we’re doing isn’t giving us the outcomes that we anticipate.

As I end, I am reminded of a visit I made to South Africa shortly after apartheid had fallen. I had the privilege of visiting Kwazulu-Natal, the birthplace of Community Oriented Primary Care. COPC is a way of practicing primary care that incorporates the social determinants of health. It was started in the 40’s by Sidney and Emily Kark, first in Israel and then in South Africa. It gave rise to the community health center movement here in the 1970’s.

During that trip I also had the privilege of spending time with young doctors who were studying at the newly formed school of public health. To this day, I have never forgotten what one young doctor said to me about her class - “We are excited to heal our country”. I hope that you too are excited about healing your country and your community.

We come to medicine out of love – love for science and the purity of reason; love of our fellow man and the wellness of communities. Be the best you can be at whatever specialty you choose because your patients deserve it. Be advocates - whether you are an interventional radiologist or a general pediatrician – because your patients and their communities need you. Understand social determinants of health and how they affect your daily practice and the outcomes you can attain with your patients. Also be mindful of the fact that where we live, work and play oftentimes play as big a role in making us sick as they do in keeping us healthy. But most of all strive for health equity.

Thank you and Godspeed.

Baltimore City Health Department Joins With Maryland Hepatitis Coalition to Commemorate Hepatitis Awareness Month

2011-05-27T07:41:00.000-07:00

The Baltimore City Health Department joined today with members of the Maryland Hepatitis Coalition (MHC) and state and local officials to recognize National Hepatitis Awareness Month. Throughout the year, the Health Department is actively involved with the prevention of viral hepatitis through its Immunization Program, Needle Exchange Program, and Perinatal Hepatitis B Prevention Project. Today we are happy to join with our partners to honor Hepatitis Heroes and to bring this issue to the forefront in an effort to fight this silent killer.

An estimated 4.4 million Americans are living with chronic hepatitis; most do not know they are infected. About 80,000 new infections occur each year, according to the Centers for Disease Control and Prevention.

The Maryland Hepatitis Coalition is an excellent example of the positive power of government and community collaboration. By honoring these Hepatitis Heroes, the Coalition is bringing more positive attention to the great work that is already being done to prevent the transmission of viral hepatitis, to care for and treat those infected with viral hepatitis, and to educate clients and the general public about viral hepatitis.

Healthcare for the Homeless clients are medically and socially complex, and often uninsured. As a local gastroenterologist, Dr. Jonathan B. Schreiber, HCH/Mercy Medical Center, has opened his practice, committing time and resources, to welcome HCH clients. Dr. Schreiber has never declined a request to care for HCH clients and has ensured HCH clients receive the highest quality care.

Please join me in applauding the MHC’s 2011 Hepatitis Heroes Honorees:

Appolo Bama, LPN of Total Health Care, Men’s Health Center for significantly increasing the number of patients vaccinated and protected against hepatitis B.
Frank Parish, RN, CIC of the Baltimore City Detention Center for implementing hepatitis B vaccination for individuals at high risk in the Detention Center.
Kathleen L. Becker, DNP, CRNP of Healthcare for the Homeless and Johns Hopkins University School of Nursing for her longstanding commitment to providing high quality care to patients at Health Care for the Homeless.
Jonathan B. Schreiber, MD of Mercy Medical Center for caring for patients with chronic viral hepatitis referred from Health Care for the Homeless.

In addition to these four individuals, we also wish to recognize Maryland Delegate Shirley Nathan-Pulliam. Del. Nathan-Pulliam has been a strong supporter of viral hepatitis prevention and care for many years. She has championed increasing funding for testing, vaccination and health services for individuals impacted by these diseases because she recognizes that a large number of people are impacted but they are not aware and they are not receiving the lifesaving services and support they need to prevent sickness and death.

For more information on hepatitis prevention activities in Baltimore City, visit the Health Department’s website. The CDC’s website also has additional information on viral hepatitis.

Should Maryland ban the sale of crib bumper pads?

2011-05-27T06:47:00.001-07:00

As reported this week in the Baltimore Sun, Maryland Department of Health and Mental Hygiene Secretary Dr. Joshua Sharfstein is considering an expert panel’s recommendation that Maryland become the first state to ban the sale of bumper pads for baby cribs. Bumper pads, used to line the inside of a crib, can be health risk and have been involved in at least 2 dozen infant deaths across the nation.

An interesting finding from the panel was that research does not show any safety benefits of crib bumpers (that is to say they do not prevent serious head injuries as marketed) and that they can in fact be hazardous. Infants can get caught in the bumpers ties and can suffocate.

I commend the Secretary for addressing this issue and encourage him to accept the panel’s recommendation banning the sale of bumper pads in Maryland. Even one death due to an unsafe sleep environment is one too many, and in Baltimore City last year, 16 babies died in unsafe sleeping environments. Most of these deaths involved babies who were not in a crib (they were in an adult bed, with or without parents or siblings) and were not sleeping on their backs.

It is important for our citizens to understand how to put a baby to sleep safely. Babies need to be Alone, on their Back, in a safe Crib free of bumpers and other items. No Exceptions. More information on this important topic can be found on our B’more for Healthy Babies Website.

National Bike Month

2011-05-18T12:05:00.000-07:00

Bike riding is good for people and communities. It improves health and fitness, and it reduces our carbon footprint as well as traffic. However, there are significant health and safety risks associated with bicycle riding. Each year, more than 500,000 people in the U.S. are treated in emergency departments, and more than 700 people die as a result of bicycle-related injuries.

Just recently we had a scare at the health department when one of our senior staff members had a tire blow out while going downhill. As you can imagine she flew over her handle bars and suffered a number of injuries sending her to the ICU. Thankfully she was ok. Her helmet was destroyed, but her skull wasn’t. The importance of helmets is that simple.

Bicycle helmets are the single most effective safety device available to reduce head injury and death from a bicycle crash, so it’s important to wear a helmet every time you ride. To maximize protection, be sure the helmet fits properly. A helmet should sit on top of the head in a level position and should not rock forward, backward or side to side. The Johns Hopkins Children’s Safety Center, run by the Johns Hopkins Center for Injury Research and Policy, offers free bike helmet fittings and also supplies reduced-cost helmets. For more information about their program, or call 410-614-5587 for more information.

Even with a well-fitting helmet, bicyclists need to exercise caution and good judgment to insure that every ride is a safe one. The League of American Bicyclists has some great safety tips for bicyclists including:

Follow the Rules of the Road
Be Visible
Be Predicable
Anticipate Conflicts
Wear a Helmet

Bike safety is not just a concern for cyclists, but for motorists as well. You can check out AAA for a longer list of tips, but the bottom line is:

Stay alert
Yield to bicyclists when turning.
Slow down and give at least 3 feet of clearance when passing.
Always check for bicyclists before opening your car door.

I was glad to see when I moved to Baltimore that work is being done to increase the number of bike lanes we have. While I haven’t yet gotten into the routine of riding to work, I have ventured out on my bike. If you see me around on my hybrid, make sure to wave!

In recognition of National Bike Month, the Baltimore City Health Department will promote the safe use of bicycles throughout May by participating in BikeBaltimore, the Department of Transportation’s bike program. BikeBaltimore organizes a variety of events around Baltimore City to encourage safe bicycle riding, from bicycle maintenance to group rides.

How are you planning to celebrate Bike Month? Do you use biking as a way to stay fit? Can you offer any other safety tips for cyclists? Let me know in the comments.

Healthy Baltimore 2015

2011-05-10T08:37:00.000-07:00

Last month, the Robert Wood Johnson Foundation issued the second annual County Health Rankings. As it did last year, Baltimore City ranked last in the state.

One statistic in particular stuck out: 14,887. That’s the number of years of potential life lost before the age of 75. Put simply, far too many Baltimore City residents are dying before their time.

Statistics like these give great urgency to the work we do to improve the health of our city, our neighborhoods and our residents. It also makes clear that traditional medical or public health approaches aren’t working and it’s time to try something different.

That conversation starts today with the release of Healthy Baltimore 2015.

This comprehensive health policy agenda highlights 10 priority areas that account for the greatest morbidity and mortality in Baltimore. These areas were chosen because there are evidence-based interventions proven to make a difference. The plan looks at the relevance of where we live, work and play on health outcomes, as oftentimes they play as significant a role in making us sick as they do in keeping us healthy.

The city has set ambitious, yet reachable, improvement goals for the following priority areas:

1. Promote access to quality health care for all.

2. Be tobacco free.

3. Redesign Communities to Prevent Obesity.

4. Promote Heart Health.

5. Stop the spread of HIV and other STIs.

6. Recognize and Treat Mental Health Disorders.

7. Reduce Drug Use and Alcohol Abuse.

8. Encourage early detection of cancer.

9. Promote Healthy Children and Adolescents.

10. Create Health Promoting Neighborhoods.

For more information on the specific indicators we will use to measure progress in these areas, please view the full Healthy Baltimore 2015 report.

As you can see, there is much work to be done. Healthy Baltimore 2015 makes clear that we all play a role in improving the health of our city.

Over the course of the next several weeks to months, we will work with partners throughout the city to flesh out a 3-pronged approach to moving the needle for each of the leading indicators, including policy development; prevention, quality, and access; and community engagement. Later this spring, senior leaders within the department will visit communities around the city to share this plan and the updated neighborhood health profiles. We hope communities will put this information to use in designing new strategies and interventions for tackling the top priorities they identify for creating health promoting environments.

Let me be clear: the health department alone cannot successfully execute Healthy Baltimore 2015. We welcome all motivated neighborhood leaders, individual citizens, academic institutions, community-based organizations, business owners and the media to join us in this effort as partners in health.

Partners can contribute to the success of Healthy Baltimore 2015 in many ways. These varying levels of engagement include, but are not limited to:

Communication – displaying or distributing health information materials within each of the ten priority areas.

Facilitation – actively participating in interventions such as incorporating wellness at work programs into the business day.

Integration – actively considering the potential health impacts of pending business or policy decisions.

To become a partner, please email me at health.commissioner@baltimorecity.gov. Together, we can reshape the landscape to make Baltimore City a place where all residents realize their full health potential.

Virtual Supermarket Program Celebrates Successes

2011-04-13T10:09:00.000-07:00

One of the reasons I started this blog was to use this space to mark the achievements of Baltimore City Health Department programs. Last night, Laura Fox, Coordinator of BCHD’s Virtual Supermarket Program, joined Dr. Andres Alonso, the board of education, George Washington Elementary principal Amanda Rice, and students in celebrating the expansion of the VSP to George Washington Elementary School as another step towards eliminating Baltimore’s “food deserts.”

Food deserts are areas where residents have little or no options for buying healthy foods. Oftentimes families in these areas have to travel over a mile to access healthy and affordable foods. George Washington Elementary is located in a food desert.

It has been a wonderful partnership with George Washington Elementary and the Y of Central Maryland as the school community resource partner. We see schools as ideal centers to model healthy behaviors. We hope that the success at George Washington Elementary will eventually lead us to expand to other Baltimore public schools located in food deserts throughout the city.

Last night was not the Virtual Supermarket’s only cause for celebration. Famed food author and New York Times columnist Mark Bittman mentioned the VSP in a recent post about ways cities can increase access to healthy foods. I am proud that Baltimore’s program is quickly becoming a national model for innovative ways to address the critical problem of food access.

Baltimore Celebrates National Public Health Week

2011-04-06T07:21:00.001-07:00

This week, communities across the country are joining together for National Public Health Week, a time dedicated to recognizing the contributions of public health and highlighting issues of importance to improving health. During the week, the Department of Health and Mental Hygiene encourages Marylanders to learn how to prevent injuries in recognition of this year’s theme, “Safety is NO Accident: Live Injury-Free.” Injuries are one of the most serious and expensive public health problems in Maryland, and unlike other leading causes of death, injury is a risk for all age groups and often can be prevented. The Baltimore Sun points out that simple steps like “using seatbelts on every trip, not using cell phones while driving and wearing a bike helmet” can go a long way toward injury prevention.

You can also work toward a safer, healthier Baltimore by attending one of the following health fairs taking place across the city this year:

Loyola University - April 7, 2011 - 11:00AM - 2:00PM

4501 Charles Street

For additional information, contact Linda Januszkiewicz at 410-617-5055 or ljanus@loyola.edu

Morgan State University - April 8, 2011 - 12:00PM - 4:00PM

1700 E. Coldspring Lane (Hurt Gymnasium)

For additional information, contact Gillian Silver at 443-885-4146 or gillian.silver@morgan.edu

Elev8 Baltimore(EBDI) @ East Baltimore Community School - April 9th from 11:00AM - 3:00PM

110 N. Wolfe Street @ Chase Street

For additional information, contact Adriann Anderson at443-703-3671 or adrian.anderson@bmsi.org

Pushing the envelope

2011-04-05T14:31:00.000-07:00

April is STI Awareness month and this year’s emphasis is on the importance of getting young people tested. Focusing efforts on youth and young adults is important because they are more likely to engage in high risk sexual behavior. Additionally, the consequences to them of untreated STI’s can have long lasting effects such as infertility.

Testing and treating individuals for STI’s in the age of the internet has become a hybrid of good old-fashioned public health practice and digital sleuthing.

For some people, the internet has become a means for arranging shorter term, often anonymous and often unsafe sexual encounters. This practice has added a new and challenging obstacle to our work of intervening in the spread of sexually transmitted infections. Everyday, public health staff in Baltimore and throughout the country interview people diagnosed with HIV, syphilis, or other STIs to provide appropriate education about STIs and to ensure that the person has medical care. We also reach out to their sex partners so they can get appropriate and timely medical care.

Until recently, a typical scenario when public health staff asked the patient about his or her sex partner(s) would be “I met him/her on the internet. We agreed that we would meet at an agreed to location in 45 minutes.” When asked how that person can be contacted, the patient typically says “I only know his/her screen name: ‘#1hotbodi’”. Prior to this month, that was typically the end of the public health intervention.

Now, however, the Baltimore City Health Department and the Maryland Department of Health and Mental Hygiene’s Infectious Disease and Environmental Health Administration are implementing internet partner services (IPS) to intervene in the spread of sexually transmitted diseases. Working with a nationally recognized consultant and three of the most heavily utilized “hook-up” sites in Baltimore and Maryland, we’ve developed a program to maximize the number of sexual partners we treat. The joint effort is critical because oftentimes persons like those described above have no idea where the person they meet lives. Close coordination between the city, the state, the counties and even other states is essential to reducing our rates of STI’s and HIV.

The program has been in effect four weeks and already we’ve been able to reach people exposed to an STI or HIV from places as far away as New York and are enthusiastic about the new program’s potential to intervene in the spread of disease.

Kegasus? Really?

2011-03-31T14:19:00.000-07:00

Earlier this week, the Maryland Jockey Club unveiled a controversial new advertising campaign for the Preakness, Maryland’s leg of the triple crown of horse racing.

The star of the show isn’t the beautiful horses, or the determined jockeys who ride them to glory. Instead, we’re given Kegasus, a centaur who loves to party. REALLY? Why not Barney from the Simpsons, or other media symbols of alcohol overindulgence that appeal to largely adolescent boys?

Jockey Club President Tom Chuckas concedes the ads are designed to bring 21-40-year-olds out en masse for infieldfest, a big party on the track infield. The campaign, he told the Baltimore Sun, “talks their language.” “We have never hidden the fact that we want people to come to the infield and party.”

Everyone loves to have a good time. The obvious problem here is that advertising ‘bottomless beer mugs” promotes binge drinking. Binge drinking, defined as consuming more than 4 (women) or 5 (men) alcoholic beverages on a single occasion, is especially problematic amongst young adults. According to the Robert Wood Johnson County Health Rankings, released the same day, in Baltimore City, 16% of people contacted in a CDC random telephone survey reported binge drinking at least once in previous 30 days. The national benchmark is 8% (90^th percentile).

Excessive drinking is a risk factor for a number of adverse health outcomes such as alcohol poisoning, hypertension, acute myocardial infarction, sexually transmitted infections, unintended pregnancy, fetal alcohol syndrome, sudden infant death syndrome, suicide, interpersonal violence, and motor vehicle crashes.

Advertisers have a social responsibility to tell the truth about what they are selling. The truth in this case is that no where on the infieldfest website is there any message about the importance of drinking responsibly.

Legendary ad man Bill Bernbach said, “All of us who professionally use the mass media are the shapers of society. We can vulgarize that society. We can brutalize it. Or we can help lift it onto a higher level.”

Sadly, the Jockey Club has missed an opportunity to responsibly promote an event that puts Baltimore City and their sport in the national spotlight.

Snuffing out tobacco use in Major League Baseball

2011-03-30T12:24:00.000-07:00

I love baseball. I’ve been a fan ever since I can remember. I have fond memories of going to the “house that Ruth built” in the Bronx and rooting for my heroes. I played stick ball with the boys on the block and was on teams throughout my youth and into adulthood. Not only did baseball (and softball) keep me active, but it taught me the values of being a team player.

Yesterday I joined Health Commissioners from 14 other cities with Major League Baseball teams to urge MLB to prohibit the use smokeless tobacco. Baseball players are an inspiration to millions of children and adults throughout the country. They should provide positive role models and take a stand against smokeless tobacco.

Tobacco use is the number one cause of preventable death in the United States, killing more than
400,000 people each year. As cigarette smoking has declined, the tobacco industry has increased its
marketing of smokeless products and is spending record sums to promote them. But smokeless tobacco
use is itself very dangerous, causing serious diseases of the mouth, including oral cancer. In addition,
there is reason to worry that smokeless tobacco use by young persons may serve as a gateway to
cigarette smoking, this nation’s leading preventable cause of premature death and disease.

In his post "Motivation to quit chewing tobacco," Dr. Stephen Matarazzo, D.M.D., shares a poignant testimonial from Joe Garagiola, former ball player who regrets ever picking up the habit. He quotes Garagiola as saying:

“I chewed tobacco because it seemed to be the thing to do if you were playing baseball,” says Garagiola. “Everybody chewed when I was playing, and nobody knew the dangers of it.” But he’s seen the dangers since, losing three close friends to oral cancer and seeing the harmful effects of spit tobacco on other people.

“You won’t die of gum disease or yellow teeth, but develop oral cancer and it’s a terrible way to go,” Garagiola says. “Here you are with oral cancer from using spit tobacco, your jaw has been removed and you have to eat through a tube. You die one piece at a time. Spit tobacco is a horrible, horrible thing. I just wish I could get this message across to everyone.”

I urge you to join Garagiola and others as we speak out against smokeless tobacco. We need MLB to help us promote tobacco free lives.

Reflecting on Youth Violence Prevention Week

2011-03-25T06:58:00.000-07:00

As Youth Violence Prevention Week draws to an end, I am reminded of a site visit I recently conducted with one of our staff in the Office of Youth Violence Prevention, Lori Toscano.

Lori is the community liaison officer, and like me she is from New York. She has a long and impressive history working with youth including a stint as a probation officer. She’s a ball of energy who regularly monitors the two Safe Streets sites we fund to make sure they are meeting their benchmarks.

About a month ago, we visited both sites, one in McElderry Park and the other in Cherry Hill, where we are implementing the Cease Fire model developed in Chicago. It’s an evidence-based approach at reducing violence in neighborhoods by engaging individuals in activities such as conflict resolution and mediation.

As we drove I would pepper Lori with questions about the importance of the work and why we should continue. Without hesitation, she replied “I’ve been in this work a long time and I stay because no one else does it like we do and it makes me feel good when we show that we are getting results. We are demonstrating that we are reducing the amount of violence in these communities.”

In speaking with the outreach workers, what struck me the most was the eloquence with which they spoke about how they came to this demanding work. Many of them have histories of “wreaking havoc” in their communities and see this as a way of making amends. Others see themselves more through the lens of a medical model and refer to the work they do as a “vaccination (against violence) that goes into a community and works with people to help them see that there are other ways to deal with issues.” What was common to both groups was their assertion that “everybody wants a way out” of a life of violence. What they provide is an invaluable and life-saving service to their communities oftentimes on a 24-7 basis.

I remember the story an outreach worker shared in McElderry Park of what his father said to him when he visited him in jail: “It’s time for you to put a stop to this. I was in your seat and your grandfather was in your seat. I failed you. You don’t have to fail your kids.”

These are powerful stories of individuals taking responsibility for their actions and contributing to the betterment of their communities, one person at a time. And that’s the message of Youth Violence Prevention Week – that we all can play a role in reducing and PREVENTING violence in our communities.

Youth Violence Prevention Week ends tomorrow, but our prevention work and that of our partners will continue until homicide ceases to be the leading cause of death for young people age 15-24 in Baltimore City.

2011 Baltimorphosis Award Winners Announced

2011-03-25T06:20:00.000-07:00

As part of National Youth Violence Prevention Week, we wanted to take an opportunity to recognize the accomplishments of some of our city’s residents who are Standing Up and Speaking Out against youth violence. That is why yesterday afternoon at City Hall, I had the pleasure of honoring the winners of the 2011 Baltimorphosis awards.

The Health Department created this award as our way of recognizing those who join us in the fight against youth violence. On the evening news, all too often we see reports about people who have made poor choices. Faced with a choice, they chose to embrace a culture of violence.

Rarely do we get to hear about people who make the right choice. Rarely do we hear about people who are teaching kids nonviolent ways to resolve their problems. Rarely do we hear about young adults who have made a conscious decision to spurn violence and work instead to better their community, neighborhood or school.

With the Baltimorphosis awards, we hope to raise the profile of individuals who do make these right choices. Today, we recognized the following four Baltimoreans who are fighting against youth violence:

Anita Foster, who was nominated by two individuals – Ashley Moore and Ericka McRae was nominated for her passion for getting youth back in school and off the violent streets of Baltimore City.
Tard Carter, who was nominated by Daniel Webster, for his work as an outreach worker with the Safe Streets East program.
Michael Williams, who was nominated by Linda Wicklein, for is dedication to making a profound difference in the lives of Baltimore City youth, by teaching kids about the effects of violence through his own story.
Robert Madden, who was nominated by Regina Lansinger for his work in forming Helping Boys Understand, an after-school program that targets at-risk young males.

We also honored 3 Baltimore youths:

William Murphy, who was nominated by Jay Gillen, for his efforts as a member of the Baltimore Algebra Project leading his peers to renounce violence by focusing on education, positive youth employment, ending the school-to-prison pipeline, and turning away from gangs and drugs.
Tavon Smith, who was nominated by Hansberry Moore, for showing younger children in the neighborhood that they can change the direction that their life is heading, just as he was able to positively affect the direction of his life, through a strong desire and hard work to change his ways.
Molly Phillips, who was nominated by Stanley Smith for starting an started an “Anti-Bullying Campaign” at Northwestern High School.

Thank you all for being part of the solution and for contributing to help to make Baltimore achieve its potential.

Getting the Facts: The Affordable Care Act and You

2011-03-23T15:33:00.000-07:00

This afternoon I joined Congressman Elijah Cummings and Maryland’s Health Secretary Dr. Joshua Sharfstein in attending “Getting the Facts: The Affordable Care Act (ACA) and You” – a Baltimore HealthCare Access event coinciding with the one year anniversary of the ACA. It’s important we celebrate this landmark legislation because it stands to transform the lives of millions of people.

This landmark legislation is important for several reasons:

• The Affordable Care Act is a real opportunity to significantly strengthen the role of disease prevention and health promotion in tackling the chronic diseases that are causing medical costs to spiral. Diabetes and heart disease are the number one killers of Baltimoreans and others throughout the US. They are illnesses that are relatively inexpensive to prevent or control. But when people living without insurance become sick, they become dramatically expensive to treat.

• It helps us move away from a system that revolves around sickness to one that focuses on well-being.

• Thousands of people who are currently uninsured will receive health coverage. I look forward to the day when the majority of the 96,000 uninsured residents in Baltimore City will have health insurance. No longer will they have to worry about whether they should buy insulin syringes for their diabetes or pay their rent.

The federal government’s investment in health care reform will result in healthier, more productive citizens. It also will save Maryland and Baltimore City money by enabling us to prevent disease, detect it early, and manage conditions before they become severe. The ACA will reduce medical costs, driving down long-term health care spending.

The state of Maryland and Baltimore City are poised to benefit greatly from these structural and funding shifts. States will compete for more than $15 billion (over 10 years) under a new Prevention and Public Health Fund. Through new initiatives sponsored by the health department, we will be able to grow services and reach more people, tackling health disparities, improving health outcomes preventing premature deaths in the process.

The Mayor and I speak regularly about health reform and we agree that the task ahead is to ensure Baltimore City is well positioned to take full advantage of these opportunities, to work with our partners in health care to improve their readiness, and to communicate these changes to the public.

Today’s public forum was an opportunity for the community to get answers to their questions about health reform. Do you have questions about the legislation? What concerns do you have?

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Health Department Receives Two Mayor's Innovation Fund Awards

2011-03-22T05:56:00.000-07:00

This morning, I was pleased to join Mayor Stephanie Rawlings-Blake as she announced three winning proposals for Baltimore City Government’s first Innovation Fund. Mayor Rawlings-Blake created the $1 million fund this year to provide seed money for City agency program investments that will lead to long-term improved results and/or reduced operating costs but that require a “start-up” investment. The three proposals will cost a total of roughly $700,000, will save over $250,000 each year in operating costs, and could generate as much as $1.4 million annually in new revenue.

Two of the three proposals selected originated from the Health Department. The first grant for $128,000 will bring our Environmental Health inspection program into the computer age by equipping our sanitarians with handheld computer devices so they can fill out electronic inspection reports in the field. The second proposal for $174,000 will be used to upgrade the information systems at the BDC Laboratory, enabling us to expand to serve outside clients. A third winning proposal for the Department of Housing also was announced.

These awards are well deserved and will set the bar for future innovations. They exemplify the department’s goal of using technology and innovation to increase efforts in improving the City’s health. I look forward to seeing these projects come to fruition.

Here's a more detailed description of our two winning proposals:

Environmental Health – Quality Management System

We conduct over 11,500 federal, state, and city-mandated inspections annually, which includes more than 5,000 food facilities, 339 daycare and family day care centers, 325 schools, 52 recreation centers, 140 swimming pools, 180 tattoo operations, and over 3,800 complaint and disease outbreak investigations annually. In addition, we issue and collect over $2.1 million in annual licenses and inspection fees.

I recently accompanied one of our sanitarians on a visit and saw for myself the paper intensive nature of an inspection. Moving to an electronic system will allow sanitarians to move away from paper and pen inspections, manual inputting and extraction of data, paper files, and inefficient record keeping.

The grant award will pay for purchasing hand-held devices that capture all investigations and inspections conducted. Sanitarians will complete their inspection reports electronically in the field and later upload them into a database. Business owners will receive an email with inspection results on the same day!

Additional benefits include creating a web tool for allowing business owners to apply online for a new business or operating license or renew an existing license. Businesses will also be able to schedule plan review inspections online. Inspection reports for all licensed facilities captured through the QMS will be accessible through OpenBaltimore.

We anticipate that the city should recoup its investment within two years due to the estimated revenue generated and costs savings realized. In addition, we project that at least 30 minutes will be saved from standard inspections. This means that we’ll be able to spend more time helping businesses remain in compliance by focusing on quality control and education – the core of our business as a public health entity.

The system is expected to be fully operational by March 2012.

Baltimore Disease Control Laboratory – Information Systems Improvement

The BDC Laboratory has supported the Department’s communicable disease control efforts for more than 20 years. CLIA-88 Highly Complex Laboratory is accredited by the Commission on Laboratory Accreditation (COLA) and fully licensed by the federal and state governments. The BDC Laboratory has continually improved its efficiency by constantly employing increasingly more sensitive and more efficient testing platforms.

However, much of the lab’s efficiency is attributable to its use of novel software system that was developed in 1992. The software is too antiquated to be upgraded and is vulnerable to virus attacks. If the computers fail, it would require four full-time data entry clerks to manually enter and print results, a function the computerized system performs.

Not only will we be rejuvenating the information system, but we’ll be expanding to offer services to outside clients such as clinics, federally qualified health centers, and community based organizations. This will will generate additional revenue to support the laboratory and help these partner control their costs.

By realizing certain process efficiencies, a new system is expected to save the city more than $136,000 annually, in addition to the additional revenue that will be generated.

These are but two of the innovative ideas generated by the health department that were funded through the Mayor’s innovation fund. Our team at the Health Department is constantly pushing itself to do more, so I anticipate that we’ll be reporting on additional innovations in the near future.

Baltimore City Kicks Off Youth Violence Prevention Week

2011-03-21T14:02:00.000-07:00

This afternoon, I joined Mayor Stephanie Rawlings-Blake, City Council President Bernard C. “Jack” Young, Minister Cleo Walker, and many of our community partners in kicking off Baltimore’s celebration of Youth Violence Prevention Week. From March 21 – 27, 2011, activities and events will be held nationwide to spotlight the issue of youth violence, to identify strategies to combat this epidemic, and to promote the positive role youth may have in making their communities and schools safer.

Youth violence is no stranger to Baltimore. While homicide was only the 15^th leading cause of death nationwide in 2009, it was the 4^th leading cause of death among Baltimore residents and the leading cause among Baltimore City residents aged 15-24 years. A report released in 2009 by the Health Department documented the trajectory of youth violence in Baltimore by looking at both victims of violence and perpetrators of violence. The study showed that 99 percent of the youth victims and perpetrators of violence interacted with one or more child-serving administrative agency in the time period preceding the violent episode. It concluded that greater agency cooperation is critical to formulating early interventions capable of effectively reducing youth violence.

In a review of Baltimore juvenile non-fatal shootings that occurred between January 1, 2001 and March 12, 2007, 7%, or 22 of 319 victims, were either murdered or shot again non-fatally within 18 months of their initial shooting. In an effort to address this issue, the City’s Safety Protocol for Juvenile Non-fatal Shooting Victims was developed approximately three years ago. This protocol was created in an effort to prevent shooting victims from being re-victimized and /or from retaliating by assessing their safety and developing and implementing safety plans. Partners involved in this collaborative effort are the Mayor’s Office on Criminal Justice (MOCJ), the Baltimore City Health Department (BCHD), Department of Juvenile Services (DJS), the Baltimore City Police Department (BPD), and the State’s Attorney’s Office (SAO).

Recognizing violence as an important public health issue, the Health Department created the Office of Youth Violence Prevention (OYVP) in 2002. OYVP is dedicated to combating the epidemic of violence affecting our city’s young people through innovative public health programming and policy initiatives. The Office works closely with community stakeholders, state and local agencies, and public health experts on programming and citywide anti-violence initiatives to prevent youth from becoming victims or perpetrators of violence.

The Baltimore City Health Department’s Office of Youth Violence Prevention, in collaboration with city agencies and community-based organizations, is using this week to kick-off a series of events, workshops and open houses to spotlight this issue, the work being done here in Baltimore, and encourage everyone to Stand Up and Speak Out against and provide our youth with the tools they need to be successful. There are more than 70 events planned for this year’s YVP Week, including an airing of the documentary, “Concrete Steel and Paint” on Wednesday, a recognition ceremony for adults and youth making efforts to end violence in their communities, the 3^rd Annual Playing for Peace Basketball tournament on Friday and a production of the play “Where Y’all At?” on Saturday.

For more information, contact the Office of Youth Violence Prevention at BmoreYVP@baltimorecity.gov or (443) 984-3566. You can also like us on Facebook at www.facebook.com/BmoreYVP.

Baltimore City's Code Blue Program Offers Relief from the Cold

2011-03-09T10:14:00.000-08:00

While Baltimoreans enjoyed a brief reprieve from the bitter recently, anyone who has stepped outside this morning feels how brisk our city gets at this time of year.

The plummeting temperatures and wind chill present a serious danger, and that is why Mayor Stephanie Rawlings-Blake, the Office of Emergency Management, and the Department of Human Services joined with the Health Department to announce the start of the Code Blue winter weather program. This program establishes a coordinated approach to providing relief from extreme cold weather to vulnerable populations in Baltimore City during the winter season.

Throughout the winter, Code Blue days are declared based on the following criteria:

temperatures are expected to be below 25 degrees Fahrenheit with sustained winds of 15 mph or higher;
or when temperatures are expected to be less than or equal to 20 degrees Fahrenheit;
or when other conditions are severe enough to present a substantial threat to the life or health of vulnerable Baltimore citizens.

On Code Blue days, the Mayor’s Office of Human Services will open the homeless shelter at 210 Guilford Avenue for extended hours. The shelter will provide meals and sleeping quarters and will not turn away patrons. Homeless Services has also funded an overflow shelter to provide 100 additional beds for vulnerable residents. Private homeless shelters will be encouraged to use these same guidelines.

The ultimate goal of the Code Blue program is to reduce the number of deaths from hypothermia. Last year, 8 Baltimore residents died from hypothermia-related illnesses. These were highly preventable deaths. Even with the expansion of services on Code Blue days, it is important for all residents to look out for their neighbors, especially those at risk for hypothermia. Based on the historical data, we know people in Baltimore City most vulnerable include the elderly, individuals with pre-existing heart conditions, those who abuse alcohol and or drugs and the homeless. Know the signs of hypothermia: people who are hypothermic may be lethargic and confused – they can look like they’re intoxicated, when really they’re sick and need medical attention.

Extreme cold weather presents risks in addition to hypothermia as residents use prohibited alternative heat or power sources, such as a stoves and generators that may cause fire or carbon monoxide poisoning. We especially want to reach out to our seniors and other vulnerable populations who are most at-risk during these events. If one of your neighbors is without heat or power, notify 311 so that city agencies can assist them. Caution must be used even when using an approved heating source; be sure to keep space heaters and candles away from flammable materials, such as curtains, furniture and loose clothing.

Most importantly, in all seasons, you must have working smoke detectors in your house. Baltimore residents can visit any local fire station, or call 311 to make certain there are working smoke detectors in their homes. If you do not have a smoke alarm, you can get one for free from the Fire Department.

Stay warm, B’more!

BCHD's Loss of Lead Abatement Funds

2011-03-03T05:53:00.000-08:00

By now many of you have learned about the Baltimore City Health Department's recent loss of Department of Housing and Urban Development (HUD) lead abatement dollars.

While loss of these dollars is a troubling setback, it does not mean that lead abatement work will cease in the City. We will continue to do everything possible to protect the health of families with young children and prevent lead poisoning. I am pleased to report that Housing Commissioner Paul Graziano and I are working closely together to ensure that these activities continue seamlessly as abatement moves to the Housing Department. We are sharing all policies and procedures to ensure that their work benefits from the control measures put into place by the health department. We will continue our work on lead health education and inspections.

During the last four years the department’s lead abatement efforts saw several successes, including the following:

Increased the efficiency with which contractors were selected and paid through the City’s procurement system
Remediated 697 homes of lead paint risks hazards resulting in a significant increase over the previous two-year period
The number of lead poisoned children decreased from 315 in FY08 to 205 in FY10
The percentage of Baltimore City children ages 0-35 months who were tested for lead increased 9% from 2007 to 2009

However, it was clear to me during my first weeks on the job that administrative issues impacted the abatement program’s ability to demonstrate effectively the scope of work being done and the quality control measures that had been put in place. As we work to improve health outcomes in Baltimore City, I expect greater oversight will be achieved through Division Stat, an internal process I instituted for sharing program performance data.

The best way for the health department to maintain the public’s confidence is for us to continue striving for excellence as we do the work of ensuring the health and safety of Baltimoreans on a daily basis. While recent publicity has been negative, it does not reflect the health department’s level of professionalism and commitment to serving the residents of Baltimore. I want to thank all health department staff for their hard work, and I remain confident that the department’s sterling reputation will shine through this difficult period.

Weighing in on the crib safety debate

2011-02-23T11:49:00.000-08:00

Today I submitted the following letter to the editor of the Baltimore Sun:

A study released last week in the medical journal Pediatrics and reported on the Sun’s website Thursday noted alarming rates of injuries to children age 2 and under in cribs, playpens and bassinets.

This could give the wrong impression that cribs are not safe and should not be used. To the contrary, a properly assembled crib is the safest place to put a baby to sleep. However, as the article stated, two-thirds of these injuries involved falls. In 2008, 27 infants in Baltimore City did not reach their first birthday because they were put to bed in unsafe sleeping environments. These are highly preventable deaths.

Baltimore’s B’more for Healthy Babies campaign is helping lower the city’s stubbornly high infant mortality rate by educating parents and caregivers about the ABCs of safe sleep – Alone, on his or her Back, and in a Crib – every time, no exceptions.

Let’s hope the federal government’s ban on the sale of drop-side cribs, which starts in June, significantly reduces the number of young children injured in falls. But by placing infants to sleep in a safe environment, alone and on the back, in a crib, without any pillows, blankets or toys, we can save many lives - starting today.

Ending drug addiction in Baltimore, one case at a time

2011-02-22T06:16:00.000-08:00

Last Friday, I had the privilege of giving the keynote address at a ceremony to honor graduates of the Baltimore City Felony Drug Diversion Initiative (FDI). The FDI program is part of Baltimore’s innovative drug court system, which seeks to identify offenders with substance abuse addiction and guide them into treatment programs. Started in 2003, FDI offers felony offenders with drug problems the option of entering substance abuse treatment as an alternative to incarceration. This program is a true Baltimore success story, reducing recidivism rates while saving money, and has been hailed as a model for drug court programs that could be replicated around the world.

This initiative was born out of a terrible tragedy. On October 16, 2002, seven members of the Dawson family lost their lives to a senseless act of drug-related arson. Federal, state, and city elected officials, members of the clergy, and the public were enraged and demanded action. In the six years since its implementation, the Felony Drug Diversion Initiative has served close to 340 city residents, many of whom are from the Oliver community where the Dawson family tragedy occurred.

While at the ceremony, I flashed back to my days as a primary care pediatrician in the Columbia Heights section of Washington, DC. Ten years later and I will never forget Ms P – a woman in her mid-forties who looked older than her years due to drug use and incarceration. She had recently been released, was in recovery and was getting her life together. Part of getting it together was bringing her daughter to the doctor’s office for a regular check up.

Over the course of about 3 years, I saw her and her daughter on a regular basis. It was through that relationship that I came to learn the important role we all play in supporting individuals through recovery. It was also where I learned that, in order to be successful in the fight against addiction, we need to tackle it from multiple approaches.

Baltimore faces many public health challenges, and substance abuse is chief among them. The Health Department estimates that 63,000 people in Baltimore City have an alcohol and/or drug problem that necessitates treatment.

In my view, the Felony Drug Diversion Initiative demonstrates how a comprehensive public health approach can be used to break the cycle of addiction and really improve people’s lives. As an alternative to incarceration, FDI clients presenting with substance use disorders are required to make a long-term commitment of at least 18-months to seek help for a drug and/or alcohol addiction. Today’s graduates had overcome the hurdles of recovery and successfully completed their substance abuse treatment programs.

Life rarely grants us second chances. That’s why it was truly inspiring to see and hear stories of these graduates who, when given a second chance, seized the opportunity to change the course of their lives. Their achievements inspire us and reaffirm our belief that together, we can build a better, healthier Baltimore.

To see a short video of the ceremony, visit our YouTube page:

http://www.youtube.com/user/BaltimoreHealth?feature=mhum.

Take care, Baltimore.