The Health Equity Coalition Hillsborough County held its first meeting Thursday, September 2, 2010 with over 65 attendees.  The meeting, held at the Children’s Board of Hillsborough County, was meant to discuss the issue of health inequity and form a group of informed and active citizens and policy makers to address the problem and solutions for the community.   

Speakers included Dr. Doug Holt, Director of the Hillsborough County Health Department, who discussed their support of this effort.  Water Niles, the manager of the Office of Health Equity, provided background and mission of this newly formed office within the community health division.  The keynote was given by Deanna Wathington, MD, MPH Interim Associate Dean for Academic and Student Affairs, College of Public Health at the University of South Florida, who led the discussion on understanding Health Disparities and the importance of addressing these issues in our community.

She explained that health disparities are the differences in health, wellness, life expectancy, etc. that exist among different social, cultural and racial groups. These disparities exist right here in Hillsborough County and we can work together to level the playing field.

The social determinants of health are the individual lifestyle factors that affect one’s health and include:

• Income
• Social class
• The neighborhood one lives in
• A person’s occupation and what they are physically exposed to while they work
• A person’s culture and customs

After the presentation, attendees were invited to make a commitment to join the coalition and part in evaluating Hillsborough County and finding ways to make it healthier for every person in our community.  The attendees discussed that community coalition will seek to make health based changes pertinent to:

• Education
• Public policy
• The physical environment of our community

We have some highlights from the meeting in the video below.   The next meeting was set for Mid-October.

We’ve all used one before. Sometimes you’re short on time but hungry. Maybe you are visiting a friend at the hospital or can’t get out of the office for lunch. Regardless of your situation, you have likely made a food purchase out of a vending machine. What did you get? Was it a candy bar, a bottle of soda, both? The fact is, those types of choices are what the average vending machine has to offer: high-calorie, low-nutrition snacks that tide us over for a short period of time but don’t provide our bodies with anything of value. While this snack gives you as many calories (and far more fat and carbohydrates) as a meal, you won’t be full.

We want to start a conversation about healthy vending machines. We aren’t saying that candy bars should be illegal; we are saying that people should be able to choose something healthy when they need a snack from a vending machine. We think that vending machines are great. They are a convenient, reasonably priced (generally) means of getting something to eat. There is no reason that they should not be stocked with healthy options. Healthy vending machines would give people access to snacks that not only stave off hunger for a bit, but also provide nutrients.

Recently the Senate voted on a bill that would affect the health content of food provided for students in public schools. We are happy to say that the bill includes a section that pertains to vending machines. Soon, by law, public school vending machines will be required to provide some healthier options. We think that this legislation is very forward thinking. There is already a middle school in Pasco County that has done this on its own. They have replaced some of the unhealthy snacks in their vending machines with healthy ones. Guess what? The kids actually like the new choices. We don’t see any reason why this trend should not take hold in Hillsborough County. Healthy vending options would just be one more way to give our kids better quality food and promote healthy eating in general. We suggest that you bring this up at the next PTA meeting you go to.

Why not take it past schools and find out who supplies your office vending machine and tell them, too? If that doesn’t work, try the money angle. The bottom line is, if people buy the healthy options out of the vending machines and leave the candy bars and doughnuts, the distributers will make changes. They will start providing more healthy options and less processed sugar. Don’t believe us? Try it!

Healthy snacks can also be tasty snacks. Think about options like these for your next vending machine purchase.

• Unsalted nuts
• Fresh veggies(yes this is a viable option from a vending machine)
• Low fat granola bars
• Pretzels
• Reduced fat popcorn
• Fruit wraps
• Pretzels
• Baked potato and whole grain chips

SOURCES
Hillsborough County Office Of Health Equity
Fitness Magazine.com
St. Petersburg Times
Parent Dish.com

People in general are susceptible to picking up behaviors that they see going on around them. Children are more likely to be affected by their surroundings. They are still developing, both physically and mentally. Even young adults are still looking to define themselves and will learn from what they see. These mental factors contribute to children becoming smokers. Once this happens the detrimental physical effects begin to add up.

How are kids affected?

It’s estimated that 20% of our nation’s students smoke by the time they graduate high school. This is completely unacceptable. We had a national health goal to reduce high school smoking rates to 16% by 2010. We failed at achieving our goal and we failed our children. 16% is too large a number in itself; the fact that we wanted to reduce teen smoking rates to that figure shows how big the problem is. About a third of children who start smoking at a young age will never quit.

We all know about the health effects of smoking, but what about health complications for non-smokers? Every year 46,000 non-smokers who live with smokers die from heart disease while 3,400 non-smokers die from lung cancer. Some, if not most, of these deaths are a result of secondhand smoke. Several studies have even linked secondhand smoke to breast cancer.

What can we do to change things?

Considering that children learn behavior from what they see and the obvious negative effects of smoking, it is important to discuss smoking in schools. Schools are places that foster the positive development of our children. Kids go to school to learn life skills. A proper education, as well as social skills, is what should be learned in school, not smoking. It is already against the rules for students to smoke, but what about adults? Teachers, administrators and even school guests are all role models for our children. When students see them smoking, they are not getting the right message from their role models. Even if they don’t see them smoking, children are not unaware. They know what cigarette butts on the ground mean and what a teacher who smoked on a break smells like. We want to work together to get rid of this negative influence in our schools. We think that a smoking ban is necessary in all schools, both public and private.

Some forward-thinking schools are already instituting smoking bans. Almost 400 colleges and universities in the U.S. have smoking bans in place. We would like to applaud the University of Florida; they instituted a campus-wide smoking ban July 1. We love to hear about schools that are getting involved in ridding their campuses of tobacco. Spreading this philosophy around Hillsborough County is one of our goals. Let your voice be heard, whether it be at a PTA meeting or in a voting booth. The more we all do to start talking about smoking bans, the more likely it is that we will be well on our way towards a healthier Hillsborough County.

How much do you think that your lifestyle and the way you grew up affect your health? It might not be something that you consider on a daily basis, or ever before for that matter, but it should be. It’s no secret that different groups of people have different levels of heath. Some groups of people live longer, while other groups are more likely to get particular diseases. We refer to these differences as health disparities. We know health disparities exist; we can even agree that they are both unfair and illogical. The question is, “How do we eliminate them?”

One way of figuring out how to reduce health disparities is to think about what causes them in the first place. Realistically, we all grow up and live differently. We are members of different social groups, which are all subject to different social forces. These social forces all have a direct effect on our health, so they are actually determinants of health.

So what are some of the individual social determinants of health?

• Income- Like it or not, money determines a lot about what we get in life. As far as health disparities are concerned, social groups with higher incomes are often far healthier than those with smaller incomes. More money gives you more access to healthcare, especially new forms of treatment. You will be able to see how income level plays a role in some of the other factors we will talk about.
• Education- A sound education is one of the best tools we can obtain in life. Those with more education are likely to be more aware of how diseases are transmitted from person to person, how to spot symptoms of medical conditions and where to go for proper treatment. The level of one’s education directly corresponds to one’s health.
• Occupational Safety-Some jobs are more dangerous than others. Some jobs that don’t seem dangerous have worse effects on your health than others. For instance, a sanitation worker has a job that is more dangerous and unhealthier than, say, a personal assistant in an office. The sanitation worker is outside around trash and vehicle exhaust all day. Breathing in vehicle exhaust and coming into direct contact with trash can have adverse health effects. They also risk being hit by a car. The personal assistant in the office is not likely to deal with any of these factors on a daily basis. Job requirements are a social force that relate directly to health.
• Early Childhood Development- The events that make up one’s childhood will affect them forever. If children are not able to eat a healthy diet, their bodies may not develop correctly and they will likely have health problems later in life. If children do not learn good personal hygiene habits (brushing teeth, how to wash in the shower, etc.) they will probably carry these bad habits on in their adult lives. Bad personal hygiene is one of the easiest ways to get sick and stay sick. It is important that children be taught how to be healthy; these lessons will literally be with them forever.

These are by no means all of the social determinants of health. Take some time to think about how other social factors can influence people’s health. Better yet, think of ways that we can work around these social factors to increase the equality of health in our community.

The face of the United States is changing, literally. As a nation, we are becoming more diverse and the individual subgroups that make up our country are changing in size and influence. You can look around Hillsborough County and see how diverse we are. We are lucky enough to have many different cultural groups providing insight and helping to shape our community. While it is great to have the benefit of being able to weigh multiple points of view when making decisions that affect us all, we must learn to work together. We do not want anyone to forget where they come from; we want them to bring their own cultural ideas to the table so that we can find a variety of ways to make our county better.

Basically culture is what binds people together. Culture itself is comprised of many elements: language, religion, family structure, beliefs and values are all factors that help determine culture. Culture plays a huge role in determining who we are and how we see the world. We all must remember that even though we share the same geographic area, our community is made up of many different cultures with different schools of thought. Finding and implementing ways for different cultures to work together successfully towards common goals is called cultural competency. Everyone must respect the fact that we are all a little different and keep this in mind when working alongside our neighbors who have slightly different backgrounds than ourselves.

Try These Ways to Achieve Cultural Competency in Hillsborough County

• Make an honest effort to learn about the beliefs and social practices of different cultures. You would be surprised how much we learn about how alike we really are when we find out about some of our differences.
• Become aware of the factors that are involved when different cultures work together. Look for ways to find common ground instead of focusing on differences.
• Remember that your culture is as different to someone from another background as theirs may be to you. Be able to evaluate your own culture so you can begin to see how others might view you.

One factor that does affect everyone, regardless of culture, is health. To live happy and successful lives we must all be healthy. While there are definitely differences in the health concerns and rates at which different cultural groups are affected by particular medical conditions, we must work together. In order to put together a series of changes that will make Hillsborough County healthier for us all, we must understand cultural competence. Take diet, for example. Food is a huge part of culture. Different cultures eat different things. One great thing that we can do to improve our health is to provide healthy snack options in vending machines. In making these changes to vending machines we have to think about everyone. Some cultures do not eat meat, while others avoid dairy products. We have to make sure that our vending machines have healthy options for everyone. If we don’t, the work we put into changing snack choices will not benefit everyone. We might be from different cultures but we are all in this together. Sharing what is important to our individual cultures with each other is vital when working towards achieving cultural competence.

Being healthy isn’t just trendy, it’s a way to improve our lives. If we work together as a community, we can improve ourselves, our loved ones and our community in general. We are lucky to have a new resource in Hillsborough County that will help us work toward our goal of being a more healthy community. Hillsborough County Health Department’s Office of Health Equity has combined forces with the Center for Disease Control and Prevention and local leaders from: government, private business as well as community and religious organizations. This group of leaders from all parts of Hillsborough county are working together to create a healthy community by first using a program called CHANGE, to evaluate some of the practices in our community and together we will develop improvements that will benefit all of us.

Community
Health
Assessment
aNd
Group
Evaluation

CHANGE has been used in other communities and has had great results. It is a tool that we can use to do things like keeping our children at all of our 243 public schools safe from second hand smoke by agreeing on making our schools tobacco free. The truth is, we all need to make some changes to our lifestyles that will make us healthier people. If we work together it will be easier because there is strength in numbers. Before we can make any changes, we need to have a little bit better idea of what we are doing now. We need to decide which of the things that we are already doing are good for us, and which things we should make some changes to in order to better ourselves. This is where the CHANGE tool comes into play. It is an organized plan that we can follow that will help us decide on a plan of action that will make Hillsborough County better for all of us. The CHANGE tool will help us get a clear idea of where we are at and where we need to go. The program is set up so that the people who are responsible for it, work with all sorts of members of the community. There is a plan in place and they begin by dividing the area into five groups.

• Community at Large- These are things that relate to areas all over the community such as shopping centers, grocery stores, parks and other places where people gather for one reason or another. It is a way of making sure that our neighborhoods are set up so that it is easier to be healthy. It includes things like: having public parks and trails set up so that people have places to play and exercise and even working with our grocery stores; asking them to provide us with healthy food options.
• Schools- This includes every school, both public and private, in the area.
• Worksites- Once again we want to include everyone. Anywhere people work; from office buildings to restaurants and even outside work places like construction sites.
• Healthcare- Keeping with the theme of not leaving anyone out, the program includes any place that people can go to for medical care. We mean: hospitals, clinics and any other medical center. It does not matter who owns them or what they specialize in.
• Community Institutions and Organization- This is anyplace that provides a service that is intended to help people. It includes community centers, senior centers, religious institutions and social clubs.

Now that we have divided up the areas to be looked at, it will be easier to see where we are at. The CHANGE tool has a plan that will be used to evaluate these five areas individually. The Hillsborough County Office of Health Equity will work with the community and use the CHANGE tool to make Hillsborough County better and healthier. It will provide us with information that lets us work directly with you, the community, so we can improve our county.