By Emily Young, Public Health Educator, Cancer Services Program Onondaga County Health Department
John* has been experiencing colorectal symptoms for a few months yet he hasn’t seen a doctor because he doesn’t have health insurance. He works full-time but his company doesn’t offer health insurance coverage. John is 55-years-old and knows that he should have had a colonoscopy when he turned 50, but he put it off because he couldn’t afford to pay the out-of-pocket cost.
John finally decided to call his primary care doctor for an appointment. His rectal bleeding and abdominal pain was getting worse and his stool was starting to look black in color. When John saw Dr. Smith*, he told her about his symptoms and how long they had been going on. Dr. Smith asked John if he had any family history of colorectal cancer or pre-cancerous polyps. John didn’t know of anyone in his family ever having colorectal cancer. Dr. Smith asked John when his last colonoscopy was. John reluctantly told Dr. Smith that he had never had a colonoscopy because he doesn’t have health insurance. Then Dr. Smith gave John some good news. She told him about the Onondaga County Cancer Services Program (CSP) which could cover the cost of his colorectal cancer screening because he didn’t have health insurance. John couldn’t believe there was a program that could help him get screened and find out what was causing his colorectal symptoms.
Dr. Smith gave John the telephone number. John called and spoke to the program’s Case Manager who quickly got him set up for a colonoscopy at a convenient location. During John’s
colonoscopy, the doctor found and removed five pre-cancerous polyps. The doctor told John he would need to follow up with another colonoscopy in three to five years. John was very thankful to Dr. Smith for telling him about the CSP and was so grateful for the peace of mind knowing that he had help with his colorectal cancer screening when he did not have the financial means to do so himself.
When was the last time you had a colorectal cancer screening? Screening for colorectal cancer is recommended for men and women between the ages of 50 and 75 years old using high-sensitivity fecal occult blood testing, sigmoidoscopy, or colonoscopy. Colorectal cancer can be prevented through the removal of pre-cancerous polyps in the colon and/or rectum. For men and women without health insurance or those who have other barriers to accessing screenings, the CSP provides free colorectal cancer screening. Uninsured men and women may call 435-3653 to register for their free screening.
To kick off 2017, I would like to make you aware of a new and important document that is now available. A community health assessment (CHA), also known as community health needs assessment (CHNA), is performed on a regular basis to identify key health indicators in a community through a collaborative, systematic, and comprehensive data collection and analysis process. The indicators for interventions are selected after active input from the community.
The Onondaga County Health Department (OCHD) worked with Crouse Health, St. Joseph’s Hospital Health Center, and Upstate University Hospital in this comprehensive process throughout 2016. We also worked with several community-based organizations. The yearlong effort has resulted in shared ownership of community health improvement, including assessment, planning, investment, implementation, and evaluation. Various strategies are aimed to address disparities among subpopulations, while improving community engagement and accountability. We also placed a strong emphasis on evidence-based interventions, while encouraging innovative practices with thorough evaluation and continuous improvement.
A community health improvement plan (CHIP) is a long-term, systematic process to address the identified public health problems in a community, following a thorough assessment (CHA).
Based on Onondaga County’s CHA, two priority areas were selected by OCHD and the partner hospitals to address during the 2016-2018 cycle:
Promote mental health and prevent substance abuse. We will give special attention to the ongoing opioid epidemic and its relationship with mental health.
Prevent chronic disease: This will focus on improving nutrition and physical activity by changing the environment.
To fully engage the community in this effort, a survey on health issues was created and distributed. The survey was completed by almost 3,000 individuals, and provides an eye-opening perspective into the true voice of our community. Review the summary of the results.
The full CHA / CHIP is an easy read and will be helpful to anyone. For example, identifying racial and geographic disparities in the rate of emergency room visits and hospitalizations in the diabetic population can help support the need for resource allocation to improve care.
Together we will make our community a better place for everyone! Please join our hands in achieving this in 2017!
By Emily Young, Public Health Educator, Cancer Services Program
In October the leaves are changing colors and signs of pumpkins are all around, but in my world, I see pink! The Onondaga County Health Department’s Cancer Services Program (CSP) is partnering with several local pumpkins patches and diners to raise awareness about the importance of women getting routine mammograms. Look for our pink pumpkins when you’re out and about this month!
Pink pumpkins are a colorful way to promote the importance of screening for breast cancer. We know that breast cancer is the most common cancer among women in the US, no matter race or ethnicity. But there is good news! Breast cancer that is found early when it’s small and hasn’t spread is usually easier to treat and has better outcomes. A mammogram is the best test to detect breast cancer early.
By Jackie Shostack, MSEd, Public Health Education Supervisor
Bureau of Health Promotion and Disease Prevention
Onondaga County Health Department
It’s been a great summer and I hope everyone’s been enjoying the outdoors. Onondaga County has so many beautiful parks to explore and play in. However, when you are outside, you need to play it safe! This time of year not only brings nice weather but it also brings ticks. And with ticks, we see Lyme disease.
A couple of weeks ago, my son was at a camp with a group that went hiking through the woods. When they returned from their hike, they partnered up and did a tick check on each other as well as thoroughly checking themselves. When he told me this, I realized that as a health educator, I talk to groups in our community about how to protect themselves from Lyme disease but I never really educated my own family and friends about it and what they need to do to prevent tick bites! Now I include my own circle of family and friends in the conversation about how to protect themselves from Lyme disease. You should do this too!
Lyme disease is caused by the bacteria, Borrelia Burgdorferi, which is carried by deer ticks. Specifically, the black legged deer tick. Not all deer ticks are infected with the bacteria, but you need to do everything you can to protect yourself from tick bites. The good news is that we can prevent Lyme disease and it’s important that we all know what to do when we are outdoors, whether it’s hiking on a trail, playing at a park, or just enjoying your own backyard. If you find a tick attached to your skin, don’t panic! Remember, an infected tick needs to be attached for 36 to 48 hours before they can transmit Lyme disease bacteria. So, take a deep breath, relax, and find a pair of fine-tipped tweezers to remove it carefully. Visit the Onondaga County Health Department’s webpage to see a video on how to properly remove a tick. Once you have removed the tick, keep an eye on the bite site for 30 days. You should consult your health care provider for any questions you may have regarding symptoms, testing, and treatment.
Don’t forget about your pets. They can also bring ticks into your home. Talk to your veterinarian about tick control products. You’re not only protecting them but treating them also will help prevent your pets from bringing ticks into your home. So, don’t be afraid to go outside and have fun and bring your pets along too!
For more information so you can educate others, please see the resources below.
Along with spring flowers, the season usually brings home repair projects. If you are thinking about doing some home repairs or remodeling projects, which may disturb old paint, I urge you to take safety precautions. Lead paint and lead dust continue to be the major source of lead exposure for childhood lead poisoning in Onondaga County. If your home is one of the 77% of Onondaga County homes built before 1978, it may contain hazardous lead paint and lead dust. Before you start your spring home repair and/or remodeling projects, I would like you to consider the following questions:
Was your house built before 1978?
Will you be working on painted surfaces?
Have you had the paint tested to see if it is lead-based paint?
Are you planning on hiring someone? Are they EPA Lead Certified?
Do you know what safety precautions you or your repair man should use to protect yourself and your children from hazardous lead paint/lead dust?
Do you qualify for a lead home repair grant?
Remodeling projects, home repairs, and normal wear and tear of painted surfaces like opening and closing windows and doors can create lead dust. Young children and pregnant women are especially at risk for exposure to lead paint and lead dust. In 2015, 391 individual homes were inspected by Onondaga County Health Department lead inspectors for lead hazards. Of the homes inspected, 86% were found positive for lead and will require repairs.
When remodeling an older home, we want you to WORK SMART, WORK WET, and WORK CLEAN. It is important to follow some safety steps:
Keep pregnant women and children out of the work area
Enclose the work area using heavy plastic (6 mil)
Use a spray bottle to wet an area before sanding or scraping
Avoid eating or drinking in the work area
Wear a mask and wash your hands often with soap and water
Clean up the work area using wet cleaning methods, only use a HEPA vacuum, carefully fold up used plastic, place it in a sealed garbage bag and put in the trash.
Let’s treat homes, not children. There are resources to assist you! Visit www.ongov.net/health/lead to get more information about:
By: Indu Gupta, MD, MPH, Commissioner of Health Contributing author: Frances Daye, SUNY Cortland student and intern with the Bureau of Disease Control
As we acknowledge 2015 World AIDS day in Syracuse NY, I cannot help but look back more than 30 years, when the first 5 cases of AIDS were reported. That was 1981. Eight years later, I met Mr. A and Mrs. B, two unrelated patients in the Emergency Room of a hospital in New Jersey where I was a medical resident. I still remember the fear and questions in their eyes!
Mr. A did not share much information and was quietly sitting on a corner bed in the Emergency Room. He was nervous and very suspicious of any question that I asked him. Mrs. B was a very lovely woman but was visibly angry and depressed at the same time as she told me her history of how she got the virus. “From my husband,” she said. “He did not share his positive status with me”. She explained that she was not sure if he intentionally withheld that information from her but it was not important at this point. I tried my best to comfort her, but doctors unfortunately did not have many answers then.
Both of these patients were treated for AIDS. In those days medical communities were struggling to find the right medications to treat the many manifestations of this new aggressive illness caused by HIV and were racing to find a solution to stop it. Both of these patients recovered well and were discharged from the hospital in stable condition. I do not know how well they did in the long term since that was the peak of the AIDS epidemic.
After the completion of my medical training, I saw patients with HIV and AIDS who did well and have continued to do so because of scientific breakthroughs in the following years. Every now and then, I still saw some unexpected clinical presentations in the hospital; even in the last 5 years. Mr. C, 30 years old, and 55 year old Mr. D were both admitted with worsening pneumonia. They both failed to respond to traditional antibiotics. Each denied any high risk history which raised our suspicions for HIV/AIDS. Their clinical course was very much suggestive of such a diagnosis.
For Mr. C, we started treatment for pneumonia, which usually presents with AIDS, without waiting for his test result since he was getting rapidly worse and time was precious. We also obtained a diagnostic test to confirm our suspicion. His test came back positive. When I spoke to him after, he quietly admitted that he was told of his positive HIV test about 10 years ago by the blood bank when he volunteered to donate blood at the Red Cross. He did not believe the result, never shared this information with anyone, never saw a medical provider, nor repeated the blood test. He continued to work and remained sexually active. He also admitted that he was afraid that if he told people of his status, he might be treated differently. After treatment, he improved rapidly and was connected with resources after his discharge. This step was very important to link him to a provider for his proper follow-up for close monitoring and also very important for his access to all the medications to control transmission of the virus.
Mr. D, 55 years old, was more stable and he continued to deny his HIV positive status, despite a positive final lab result. He was treated and he did improve. But the challenges remained for his follow-up care with the doctor, his adherence with the medication regimen since he did not want to accept the diagnosis, and his follow-up regarding his risk to his partners. Finally our persistence paid off and he started to shift his resistance! Why were these efforts important? By providing access to proper care it helps to reduce the chance of transmission of virus.
According to the CDC, approximately 50,000 new HIV infections are estimated to occur in the U.S. every year. About half (27,000) were diagnosed with AIDS. Currently it is estimated that 1.2 million people in the United States are living with HIV infection. Almost 1 in 8 (13%) do not know of their infection, a significant public health concern.
Who is at risk? Gay, bisexual, men who have sex with men (MSM), and African Americans face the most severe burden of HIV. In Onondaga County, the rate of new HIV infection has increased to 10 per 100,000 in the 2011-13 timeframe. Significant racial disparity exists in new HIV diagnoses. Rising rates of syphilis, other STDs, rising rates of heroin abuse especially with IV use, the problem of untreated mental health, poverty, and homelessness all increase the risk for HIV.
So why recognize World AIDS Day? It is held on December 1st each year and is an “opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV and to commemorate people who have died.” Each year, millions of people all over the world come together in solidarity for those who have lost their lives, those who are living with HIV, and the families of those affected. According to the World Health Organization (WHO), since the pandemic began in the early 1980s, almost 78 million people have become infected with the virus and estimated 39 million people have died. An additional 35 million people were living with the disease in 2013. These numbers make HIV one of the most destructive pandemics in history. World AIDS Day reflects on what has been achieved both nationally and globally regarding treatment and prevention but also what still must be done to end the pandemic.
This day is important because despite the advances that have been made scientifically and socially, there is still a long road ahead before the goal of “Getting to Zero” new cases can be achieved. This day is used as a reminder to governments and individuals that HIV is still a grave problem and there is still a need to educate, increase awareness, reduce prejudice, and raise funds for AIDS research.
Although researchers have not been able to find a cure for HIV, much headway has been made through research. Due to antiretrovirals and other drugs, HIV is now seen as a chronic disease. Recently people who are at high-risk for contracting HIV are urged to take pre-exposure prophylaxis or PrEP which is a pill taken daily to remain HIV negative. People who use PrEP are tested for HIV and other sexually transmitted diseases (STDs) every three months.
One of the key goals of World AIDS Day is to remind people to protect themselves. We have to protect ourselves every day not just on World AIDS Day. Some ways we can protect ourselves from contracting HIV is by educating ourselves, the more we know about the disease the better we are at taking the right precautions to prevent it. Preventive steps are to practice safe sex by using a condom every time you have any sex, avoid sharing needles and contact with other people’s blood and get tested and treated for all STDs because already having an STD puts an individual at a higher risk for contracting HIV.
Every year, organizations and clinics can choose to host activities that can help raise awareness about HIV/AIDS and provide HIV testing opportunities within their communities. This year, there are exciting events happening all over Syracuse and the Onondaga County Health Department won’t be left out! On November 30th, the Health Department participated in a health fair at the Southwest Community Center by testing the public’s knowledge and providing incentives. On December 1st in the OCHD’s STD Center we will have exciting health education activities that have been created by our student interns. That evening, we will be joining with the CNY HIV Care Network for a candlelight walk from the SU Campus to University United Methodist Church for an Interfaith Candlelight Memorial Service. Come join us!
By Indu Gupta, Commissioner of Health Contributing Author: Jenny Dickinson, Cancer Services Program Coordinator
On October 15th, the Onondaga County Cancer Services Program had the honor of thanking seven local breast cancer survivors for taking part in “Celebrating Survivors: A Traveling Roadshow”. The posters traveled over a 6 week period to 16 locations throughout Onondaga County, primarily in the city of Syracuse.
At the recognition event, our Health Commissioner, Dr. Indu Gupta, recited an inspiring poem she wrote in honor of the occasion:
A Poem by Dr. Indu Gupta
Once you were told of the diagnosis and chance of recovery,
Your days and nights suddenly became dark and gloomy,
You were in denial and angry with no end to your agony,
Why me…was the question and anxiety of new identity?
But after this struggle, you took charge of your destiny,
You changed from feeling pain to Hope and recovery,
You changed your struggle to acceptance and Victory,
And changed your tears to your spiritual journey,
You shared unconditionally your amazing life journey,
Oh beautiful women, you are my inspirational story.
Please meet these amazing women of the
“Celebrating Survivors” project: