S O U T H W E S T U T A H P U B L I C H E A L T H F O U N D A T I O N

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E-CIGARETTES PG. 24 WALKING THROUH TIME PG. 20

The story behind this controversial device

How walking inspired great minds from history

FAMILY DINNER PG. 19

Interview with The Food Nanny

IRON WASHINGTONBEAVER GARFIELDKANE75 West 1175 NorthBeaver, UT 84713(435)438-2482

601 East CenterPanguitch, UT 84759

(435)676-8800

260 East DL Sargent Dr.Cedar City, UT 84721

(435)586-2437

445 North MainKanab, UT 84741(435)644-2537

620 South 400 EastSt. George, UT 84770

(435)673-3528

S O U T H W E S T U T A H P U B L I C H E A L T HD E P A R T M E N T P R O G R A M S

OUR MISSION IS TO: PROTECT the community’s health through the PROMOTION of wellness and the PREVENTION of disease.

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PUBLISHER FOUNDATIONBOARD

DavidBlodgett , MD

ChrisWhite

Jef f Shumway

ToddStir l ing

MANAGINGEDITOR

DESIGNER

Jef f Shumway

David Heaton

Kindal Erickson

I'm pleased to introduce the eighth issue of Health to the residents of the five counties served by the Southwest Utah Public Health Department (SWUPHD). Those of us involved in public health realize that the better we do our job, the less you'll probably hear about it. Insuring the safety of air, water, and food, along with the prevention of contagious or chronic diseases, is often a behind-the-scenes business.

This publication is part of our ongoing effort to get health-promoting information into the hands of our community members, to assist you in making the best health decisions for you

and your family. We can do our best to present meaningful, evidence-based information, but it's up to you to take action. It's our goal to help you do that.

Sincerely,

David W. Blodgett, MD, MPHSWUPHD Health Officer & Director

The entire contents of this publication are Copyright©2014 Health (the magazine of the Southwest Utah Public Health Foundation) with all rights reserved and shall not be reproduced or transmitted in any manner, either in whole or in part, without prior written permission of the publisher. Health magazine hereby disclaims all liability and is not responsible for

any damage suffered as the result of advertizements, claims, and or representations made in this publication.

THIS MAGAZINE IS A PUBLICATION OF THE

Jeff, David, Chris, Dr. Blodgett, Todd, & Kindal

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@ S W U p u b l i c h e a l t hNOW ON INSTAGRAM @SWUHEALTHFOLLOW US

S W U H E A L T H . O R G 5

M A L A R I A

THE FIGHT AGAINST MALARIAThe history of a worldwide diseaseby Lori McGuire, RN

H A N T A V I R U S

KILLER MICEThe story behind this rare but deadly virusby Lisa Starr, RN

U S P S T A S K F O R C E

CHECK YOUR SOURCESThe search for trustworthy health informationby David Blodgett, MD, MPH

A I R Q U A L I T Y

BLUE SKIESHow clean is our southern Utah air?by Robert Beers

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E X E R C I S E

WALKING THROUGH THE AGESThe healthy walking habits of historical figuresby David Heaton

F A M I L Y M E A L T I M E

FOOD FOR THOUGHTWhen families sit down and eat together, every-one benefitsby Shalyce Oman

F I L M R E V I E W

WEIGHT OF THE NATION"To win, we have to lose"by Cambree Applegate

N U T R I T I O N

GOING GREEN WITH SMOOTHIESHaven't tried a "green drink"? You're missing outby Sara Fausett, RD, CD

P R E P A R E

WHEN THE HOSPITAL IS FULLCommunity Information and Support Centers by Paulette Valentine

T E X T I N G A N D D R I V I N G

FIVE SECONDSA call to action - put the phone awayby Kaysha Price

I N F O G R A P H I C

BACK TO SCHOOLVACCINATIONSAre your kids caught up on their shots?by Kindal Erickson

V A P I N G

CLEARING THE SMOKEThe rise and regulation of e-cigarettesby David Heaton

Q U I Z

FLU 101Everything you need to know about seasonal flu

C H O L E S T E R O L

UNDERSTANDING THE NUMBERSInterpreting cholesterol screeningsby Todd Stirling, PA-C

U P D A T E

WATER LAB SUCCESSKeeping your public pools safeby Robert Beers

T H E F O O D N A N N Y

FAMILY DINNER IS BACKImprove your family's nutrition and relationship

Q U E S T I O N S O R C O M M E N T S ? Email dheaton@swuhealth.org

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WALKING THROUGH THE AGES:Special thanks to the Utah Shakespeare Festival for helping us costume Jane Austen, Thomas Jefferson, and Ludwig van Beethovenstory on page 20

ON THE COVER

ALSO @SWUHEALTH

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BLUE SKIESAIR QUALITY IN SOUTHERN UTAH

Robert BeersSWUPHD Environmental Health

Division Director

People enjoy Southern Utah for many reasons, but the clean air and environment are often mentioned by tourists and res-idents alike. Most areas in our region enjoy over 300 days of sunshine each year. Public opinion polls indicate that people throughout the state and nation are concerned about the qual-ity of the air we breathe and the steps being taken to improve air quality.

The Southern Utah Air Quality Task Force was formed in 1996 at the request of St. George City Mayor Daniel McArthur. The initial goal was to address fugitive dust concerns, meaning dust blown in from outside the area. The Task Force has also begun to address additional air quality concerns. Represen-tatives from public health, government, industry, transporta-tion, business, economic development organizations, and citi-zens throughout Washington County have been involved with the Air Quality Task Force since its creation.

The Task Force holds an annual Air Quality Summit to ed-ucate community leaders and the public about current issues and efforts affecting the area. The 5th Annual Air Quality Summit is tentatively planned for February 2015.

The creation of the Task Force led to a partnership between the Southwest Utah Public Health Department and St. George City to operate air quality monitoring equipment bor-rowed from Summit County during the summer months from 2008 to 2011. St. George City purchased its own monitoring equipment in 2012. St. George plans to purchase a second air

monitor for the end of 2014. This equipment is used to moni-tor fugitive dust in various areas of St. George.

Poor air quality can have a negative effect on people and the environment. Obviously, people with asthma or other med-ical concerns are more susceptible to air pollution. Individ-

uals who experience breathing problems should remain indoors when poor air affects the area.

Fortunately, air quality in south-ern Utah is generally very good

and is much better than the nearest metropolitan areas. Local air quality can be affected by weather patterns, climate, indus-trial activities, automobiles, high winds, construction or exca-vation work, forest or brush fires, and agricultural burning. Poor air quality in Southern Utah is almost always a direct result of regional fires, high wind events, or unusual weather patterns.

Southern Utah does not often fall outside air pollution stan-dards set by the Environmental Protection Agency. Occasion-al inversions are generally short-lived due to the mild climate. For this reason, southern Utah is not required to enforce “No Burn Days” or other restrictions that are broadcast by news media along the Wasatch Front.

The Utah Department of Environmental Quality has the re-sponsibility to regulate state and federal air quality laws and regulations throughout Utah. Visit airquality.utah.gov for ad-ditional information.

Most areas in our region enjoy over 300 days of

sunshine each year.

S W U H E A L T H . O R G 7

PREVENT

The last issue of Health Magazine announced the opening of a new water lab in St. George (What's in the Water?, Sum-mer 2014). The Southwest Utah Public Health Department (SWUPHD) created the lab to help operators of drinking wa-ter systems and swimming pools improve water quality and prevent the spread of water-borne disease.

The lab began receiving and analyzing water samples in Oc-tober 2013. The response has been impressive. The Lab per-formed 36 bacteria tests in April, 392 in May, and 445 tests in June. About 550 tests are expected for the month of July 2014.

More importantly, swimming pool compliance with bacteria testing requirements has seen a remarkable improvement. Health department staff report that bacteria testing compli-ance for local public pools has increased from approximately 25% to more than 90% in just over three months. Please call first for sample collection procedures and additional infor-mation.

SWUPHD Water Lab Information:St. George Office: Mondays through Thursdays from 8:00 a.m. to 4:00 p.m. (#435-986-2580)

UPDATE:

WATER LAB SUCCESS

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KILLER MICEHANTAVIRUS IN SOUTHWEST UTAH

Hantavirus was first recognized in the U.S. in 1993 and, as of 2012, a total of 616 human infections in 34 states have been reported nationally. About 75% of all cases were contracted in rural areas and 36% resulted in fatalities. Utah has reported 26 cases since 1993, in-cluding two in Iron County and one in Kane County.

Hantavirus can infect anyone, regard-less of age, gender, or race. Humans usually get infected by in-haling dust that contains dried rodent urine or feces contaminated with the vi-rus. Infection can also oc-cur if contaminated mate-rial enters an open cut; or directly into the mouth, nose or eyes. So far there has been no evidence of person-to-person transmission. There are four species of mice that can carry hantavirus. Only one, the deer mouse, is found in southwest Utah. Symptoms include fever, cough, muscle aches and gastrointestinal upset within one to five weeks of exposure. Hanta-virus Pulmonary Syndrome can prog-ress rapidly to severe respiratory failure and shock. There is no medication to treat this virus, so critically ill victims

Lisa Starr, RNCommunicable Disease

Surveillance Nurse for the SWUPHD

are usually admitted to a hospital in-tensive care unit (ICU) where they can be supported with fluid and electrolyte balance, blood pressure control and ventilation. The mortality rate can be as high as 50%.

Although cases of hantavirus are rela-tively rare in our area, the serious risk to health when infections do occur is sobering enough to consider good pre-vention practices. To control rodent

infestation, the motto to remember is “seal up, trap up, clean up!” •Clear brush, grass, and garbage from around building foundations to elim- inate a source of nesting materials.

•Keep tight-fitting lids on all garbage cans.

•Use metal flashing around the base of wooden, earthen, or adobe dwellings to provide a barrier against rodents.

•Seal all entry holes (¼ inches or wid

er) inside and out with cement, lath or wire screening, or other patching materials.

•Elevate hay, woodpiles, and garbage cans to eliminate possible nesting sites.

•Use traps or an EPA-approved roden- ticide with bait, then properly dispose of rodents. Live trapping of rodents is not recommended.

•Don’t leave pet food out overnight. Clean up food preparation areas.

People involved in clean-ing rodent-contaminated areas should keep the

following recommendations in mind:

•Work in well-ventilated areas. Gloves, dust/mist masks, long-sleeved cloth- ing, and protective eyewear may help prevent exposure.

•Clean droppings using a wet method, rather than a dry method such as sweeping or vacuuming. Spray disin- fectant (such as diluted bleach) on droppings prior to cleaning, then use a wet mop or paper towels moistened with disinfectant to clean up.

To control rodent infestation, the motto to remember is “seal up, trap up, clean up!”

S W U H E A L T H . O R G 9

PREVENTHANTAVIRUS PULMONARY SYNDROME (HPS) CASES, 1993-2013

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Chinese medicalliterature2700 B.C.

Greek writings500 B.C.

15th centeryexplorers to New World

American Civil War

THE FIGHT AGAINST MALARIATHE DEADLY MOSQUITO

Lori McGuire, RN Nurse at the SWUPHD Kanab office

What is the deadliest animal known to man? In terms of sheer number of deaths caused, it would be the mosqui-to. It is one genus of mosquito in par-ticular– the Anopheles mosquito – that carries the malaria parasite. According to UNICEF (United Nations Chil-dren’s Fund), about one million people die annually from malaria. The World Health Organization (WHO) reports that about half of these fatalities occur in children five years and younger who live in Africa.

Malaria has been known to humans for millen-nia. Chinese medical literature from 2700 B.C. mentions malar-ia, as do 4000 year old Egyptian texts. The Greeks wrote about it in 500 B.C. and it plagued much of the Old World. The Roman Empire managed to keep the disease under control by draining marshes and developing the land. In

fact, the word malaria comes from the term mal’ aria meaning “bad air” – the bad air emanating from the swamps, which was thought to be the cause of the disease. It would be over 14 centu-ries after the fall of the Roman Empire before mosquitoes would be implicated in malaria transmission.

When Europeans first arrived in the New World at the end of the 15th cen-tury, they brought malaria with them. Malaria followed the spread of Europe-ans through Central and South Amer-

ica and then into the south of what is now the United States. By the early 19th century, malaria was occurring throughout the U.S. and in parts of Canada. Every state except what would eventually become Alaska had the dis-

ease. Malaria was a common cause of death in those days. A U.S. Cen-sus Bureau from 1850 states that 45.7 out of every 1000 deaths were caused by malaria. Over 10,000 Union Army troops succumbed to the illness during the Civil War. Even at the beginning of the 20th century, malaria continued to sicken and kill. Up to 80% of the workers building the Panama Canal would fall ill from malaria at any given time. Soldiers during both World Wars were stricken by the disease as well. The U.S. Army would spearhead the

development of chloro-quine, one of the first syn-thetic anti-malarial drugs during World War ll. An-other anti-malarial drug,

mefloquine, was developed during the Vietnam War.

In the late 19th century, with malar-ia ravaging the Indian subcontinent, a British surgeon living in Bangalore,

According to UNICEF, about 1 million people die annually from Malaria.

S W U H E A L T H . O R G 11

PREVENT

A 19th century image of Jack Frost as a Union General during the American Civil War with a caption read-ing, "Our faithful old Ally of the North, GENERAL JACK FROST, shall come and clear away the Malaria"

Now

Sir Ronald Ross, became interested in the disease. Scientists had recently discovered the existence of the malaria parasite Plasmodium, and Ross was intrigued by the hypothesis that mosquitoes spread the parasite. He spent the next four years proving this hypothesis by dissecting mosquitoes. With the knowledge of this discovery he traveled the world to develop malaria control measures, including a trip to Panama in 1904.

With the scientific un-derstanding of malaria transmission and knowl-edge of the Plasmodium life-cycle, malaria erad-ication efforts began in earnest. The effective-ness of quinine as a treatment had been known for centuries. In the early 1600s, Spanish missionaries in Peru learned of the cinchona tree. Indigenous tribes were using the bark of this tree to effectively treat fevers. Europeans exported this tree for cultivation and research and, in the early 19th centu-ry, quinine was isolated and extracted from the tree bark. It was proven to be successful in the treatment and prevention of malaria. Most of the anti-malarial medications used today are based on quinine.

In addition to pharmaceutical prevention and treatment, oth-er control measures were sought. The Communicable Disease Center, later called the Centers for Disease Control (CDC), was established in 1946 with the goal of combating malaria.

Mosquito abatement strategies were crucial. A pivotal event occurred in 1939 when Swiss chemist Paul Muller developed DDT. This insecticide, originally developed to kill a beetle that was destroying potato crops across Europe and America, was found to be effective against many pests that caused hu-man misery and death, including fleas carrying typhus and the Anopheles mosquito. By 1951, thanks in no small part to the use of DDT, malaria had been eradicated from the U.S.

Today, malaria continues to ebb and flow across the world. Of the 430 Anopheles species, about 35 are capable of spread-ing malaria and they are

found on every continent except Antarctica. North America remains malaria-free as do Europe and Australia. Malar-ia mortality in the Middle East and Southern Asia has de-creased since the beginning of the 20th century, but the risk remains throughout those areas. The WHO estimates that there were 207 million cases of malaria in 2012 and Africa continues to be the hot bed of the disease, accounting for 85% of all cases and 90% of all deaths.

If you have plans to travel overseas, consult your local health department (see page 2) to find out if your destination has any risk for malaria exposure. If so, there are prevention tips and medications available to help make your trip a safe one.

If you have plans to travel overseas, con-sult your local health department to find out if your destination has any risk for

malaria exposure.

PreventionEliminationControlPre-elimination

Phase of countrieswith Malaria

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CHECK YOUR SOURCESU.S. PREVENTIVE SERVICES TASK FORCE

David Blodgett, MD, MPHDirector and Health Officer

for the SWUPHD

It is bewildering to consider the on-slaught of information that we are ex-posed to in today’s world. As more is understood about any given topic, it be-comes even clearer that there is much that we do not know. It’s also exciting to live in a time when vast amounts of information are available and readily accessible to almost anyone. The in-ternet in particular has opened these doors so that all may learn the secrets of the ages. However, not all sources of information are equal. The modern day miracle of the internet has a downside. With very little investment in experience, educa-tion, forethought or finances, anyone can represent themselves as an expert on any issue. What people used to say about the news is now said about the internet; the joke now goes, “I found it online, so it must be true!” Even peo-ple who seem to have legitimate creden-tials, such as celebrity doctors, are often maintaining large financial operations and can be influenced by paid advertis-ers and product endorsements.

We can be easily manipulated by emo-tion and criticism, therefore a well-based online article may not be able to compete with the frequently anonymous tirades that follow it. A study published in the Journal of Computer-Mediated Communication (February 2013) found that inflammatory statements made in online comment sections can influence readers on the topic more than the ar-ticle itself!

The difficulty of navigating the infor-mation superhighway is compound-ed by the complexity of some issues. The media tends to explain issues in one-liners and sound-bites and we tend to welcome oversimplified explanations. This is the path to misunderstanding, division, inconsistency, and often downright bad information. Nowhere is this more apparent than in politics, but a close sec-ond would have to be the medical world. You don’t have to look far to see examples of this every day: coconut oil is bad for you/coconut oil is healthy. Whole wheat is nutritious/whole wheat is poison. Do statins (medi-cations for high cholester-ol) help or hinder? “Use this one weird trick to (in-sert whatever health prob-lem is being exploited)”.

Who can you trust?

There are several organi-zations that have been set up to specifically avoid the effects of politics and mon-ey on medical and public health decision making. These groups become the most credible simply be-

cause their charge is to examine and in-terpret all of the scientific data instead of advancing an agenda. Often their recommendations are controversial be-cause they are made outside of the po-litical and social environment.

How to be a healthy skepticAsk yourself these basic questions when evaluating in-formation you find online or anywhere else, especially when it affects your health:

• Does the claim fall in line with what you know about the world and common sense?

• Is the claim advocating an extreme regimen, be havior, or quantity of something? “Moderation in all things” is more than a nice phrase, and “more is better” has its limits.

• Is this an effort to sell you something or does someone’s livelihood benefit from the decision you make about the claim? Look for indications of a “paid advertisement”.

• Is the source a lone expert? In general, sources that are supported by recognizable groups of author ities in an area of expertise are more reliable than a single individual. This guideline is not foolproof, but larger professional organizations often have a process in place that helps weed out bad informa- tion.

• Are there any underlying agendas? Sources that do not have a financial or political stake in the issue are more credible. The role of governmental organizations (such as the Centers for Disease Con- trol & Prevention or your local health department) should be to put science ahead of politics, so that the public benefits from accurate, unbiased infor- mation.

S W U H E A L T H . O R G 13

PREVENTAmong the best of these organizations is the United States Preventive Services Task Force (USPSTF). Here’s a descrip-tion from their website:

“Created in 1984, the U.S. Preventive Services Task Force is an independent, volunteer panel of national experts in prevention and evidence-based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preven-tive medications.

Task Force members come from the fields of preventive med-icine and primary care, including internal medicine, family medicine, pediatrics, behavioral health, obstetrics and gyne-cology, and nursing. Their recommendations are based on a rigorous review of existing peer-reviewed evidence and are intended to help primary care clinicians and patients decide together whether a preventive service is right for a patient's needs.”

The USPSTF serves as a watchdog over health practices and helps protect against harm that may arise from over-testing and over-promising. Their recommendations can be found online at www.uspreventiveservicestaskforce.org. Here you will find evidence-based evaluations of many popular preven-tive screenings, gathered from thorough investigations and reviews of medical literature. The USPSTF makes recom-mendations on the following basis:

Grades A and B: Recommended for everyoneGrade C: Recommended only for selected individualsGrade D: Not recommendedGrade I: Insufficient evidence to recommend either way

These recommendations are supported by extensive research and documentation of the process the task force used to ar-rive at their conclusion.

Some of the recommendations of the task force may sur-prise you. For example, screening for prostate cancer using a prostate specific antigen (PSA) test received a D grade: not recommended. For years, men have been screened regularly using the PSA test. However, the task force found that stud-ies on the benefits from prostate screening could not find any benefits as far as men saved from dying of prostate cancer. In fact, several harmful effects of PSA testing were found. Out of every 1,000 men screened, 30 to 40 will develop erectile dysfunction or urinary incontinence due to treatment. Two men will experience a serious cardiovascular event due to treatment, and one man will develop a serious blood clot. One in 3,000 men screened will die due to complications from surgical treatment.

Other preventive tests that don’t make the cut:

•Screening for carotid artery stenosis (CAS) does more harm than good: D •Ovarian cancer screening for most women: D •Testicular cancer screening: D

The USPSTF caused some controversy when it found that the best use of mammograms are for women ages 50-74, and every two years. The American Cancer society had recom-mended mammograms every year after age 40.

Here are some recommended tests from the task force:

•Colonoscopies for everyone ages 50-75: A •Screening for gestational diabetes in pregnant women after second trimester: B •Blood pressure screening for all adults: A

Conveniently, the USPSTF has also released an app for An-droid and iPhone called ePSS that will display all of the recommended screenings for you, based on your age and risk factors. The app will also leave out screenings that have been shown to be unnecessary or potentially harmful, based on the data you enter. The USPSTF serves as a trusted resource that does all the heavy lifting to provide reliable information on which to base your health decisions.

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FLU 101FLU SEASON ARRIVES THIS FALL. BE READY!Protect yourself, your family, and friends against the upcoming flu season. Visit the nearest Flu Shoot-Out and get vaccinated!

BEAVERWednesday, Sept. 17, 2014EMS Shed11am-3:30pm: Drive-thru or Walk-in

CEDAR CITYSaturday, Sept. 20, 2014Health Fair - Valley View Med. Center9am-1pm: Walk-in (all ages)

ST. GEORGEWednesday, Sept. 24, 2014Red Cliffs Mall parking lot & food court8am-2pm: Drive-thru (ages 18+) 1pm-7pm: Walk-in (all ages)

KANABSaturday, Oct. 11, 2014Health Fair at High School9am-1pm: Walk-in (all ages), Flu Vaccine FREE to all Kane County residents!

PANQUITCHThursday, Oct. 16, 2014Fire Station11am-3pm, Drive-thru or Walk-in

Flu shots $18 (nasal spray vaccine $25), cash, check or credit card; or FREE with proof of the following insurances: Altius,

CHIP, DMBA, Medicaid, Medi-care(depending on HMO plan), PEHP, SelectHealth, Tall Tree, or United Healthcare

•wear a short sleeved shirt• Visit www.swuhealth for updates and consent forms (print, fill out, and bring with you to save time!)

S W U H E A L T H . O R G 15

PREVENT 2. H1N1 (also called swine flu) was a new strain that most hu-mans had no immunity from, so it caused the first flu pandem-ic since 1968. Since it is still circulating, protection against H1N1 will be included in this year's flu vaccine. H5N1 (avian or bird flu) has a 60% fatality rate and has been tracked in the eastern hemisphere since 1997. Fortunately it has not mutated enough to easily transmit person-to-person. 3. False. "Stomach flu" is not actually the flu, it's gastroenteri-tis, which can have numerous causes, from norovirus and sal-monella to giardia and chemical toxins. Influenza can cause gastrointestinal illness on occasion, but the flu is known for high fever, body aches, fatigue, coughing and sore throat. Flu victims are often bedridden from several days to two weeks. If you have flu-like symptoms, stay home and cough into your sleeve to avoid infecting others. Most people recover at home with rest, fluids, and pain relievers. You should get medical help if you experience breathing problems, altered conscious-ness, or have a medical condition that worsens with illness. 4. False. The flu is not known to be airborne. You catch the flu when the virus enters your eyes, nose or mouth. This can happen when you're in range of someone coughing or sneezing (3-6 feet) or, more likely, when you touch an infected surface and then touch your face. Respirator masks only offer protec-tion if you're providing patient care up close. 5. All of these practices will help protect you from the flu. Get vaccinated, wash your hands frequently with soap and warm water (hand sanitizer works but is second best), and make sure you're keeping a healthy immune system by manag-ing stress and getting plenty of sleep, nutrition, and exercise. 6. On average, an estimated 32,000 Americans have died from the flu annually since 2000. Flu and pneumonia rank as the ninth most common cause of death in the U.S. Over 90% of flu deaths occur in people over age 65. 7. False. Most people have no side effects from flu shots, which can include irritation and swelling at the injection site or mild flu-like symptoms as the body builds an immune re-sponse. Serious side effects are very rare (about one in one million doses). Did You Know? •Flu season starts in late fall and peaks in February in south west Utah. •Flu shots are recommended for everyone over six months of age. •Flu vaccine usually becomes available as early as September at pharmacies, clinics, and local health departments. •The Southwest Utah Public Health Department holds a "Flu Shoot-Out" in each county, providing a fast, convenient way to get immunized while participating in their annual mass-vaccination exercise. See the previous page for more in formation.

HOW MUCH DO YOU KNOW ABOUT THE FLU?

1. Influenza (or flu) is a: A) Bacteria B) Virus C) Parasite

2. The 2009 flu pandemic involved which flu strain? A) H5N1 B) H7N9 C)H1N1

3. T or F? Nausea, vomiting, and diar-rhea are primary symptoms of the flu

4. T or F? Flu is spread through the air

5. The flu can be prevented by: A) Hand washing B) Vaccination C) Healthy lifestyle D) All of these

6. On average, how many estimated flu deaths occur in the U.S. each year? A) 3,000 B) 23,000 C) 32,000

7. T or F? Flu vaccines have a lot of side effects

Test your knowledge with these questions (an-swers below):

1. Influenza is a respiratory virus, so antibiotics are use-less against it (unless you get a secondary infection, like bac-terial pneumonia). The flu virus mutates often, which is why you need a new flu shot every year. The annual flu vaccine contains three to four flu strains anticipated to be the most active in the upcoming flu season.

Flu Virus

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GOING GREENWITH SMOOTHIES

A green, nutrition-filled glass seems like an easy way to start eating healthier, less processed foods. The fruits and vegeta-bles can make a guiltless glass, as long as added ingredients don’t end up creating a glorified dessert.

FRESH IS BEST: Although green smoothies are a great way to increase fruits and vegetables in our diets, whole and fresh is best. In a study by Rolls and Flood-Obbagy in 2009, par-ticipants who ate a whole apple as a first course consumed 15% less calories throughout their meal compared to those who had applesauce, who ate 6% less calories throughout their meal. People who drank juice, with or without fiber, did not lower their calorie intake at all.

A pureed glass of fruits and vegetables is very appealing be-cause it is convenient. However, juices and blended produce make smoothies less filling because they have been converted into miniscule particles that are easier and faster to digest. A blended fruit and vegetable smoothie may leave you hungry faster than if you were to eat its components whole. The major reason why whole produce is best is that the fiber and complex carbohydrates are still completely intact. Consider it “Choice A”. As a superb Choice B, green smoothies can become part of

a healthy diet because they can replace less nutritious choices like flavored coffee and soda. In general, increasing any form of fruits and vegetables in the diet provides great health ben-efits. Green smoothies can be used as an easy way to make a snack or replace an entire meal, depending on the ingredients.

WHAT’S IN YOUR CUP? Your smoothie is only as healthy as your ingredients. The first step is vegetables. Look for spinach, celery, kale, beet greens, etc. Don’t skimp on this step. Next, add some color with fruits like berries, pineapple, plums, or apricots. Try adding healthy fats like avocados, nut butters, or seeds to make it richer. Finally, put some protein in your glass to keep you feeling full longer. Some great options include Greek style yogurt, protein powders from pea, whey or hemp, and seeds such as chia, pumpkin, or flax. Ingredients in green smoothies do not always have to be the same. Com-binations and amounts may change depending on whether it is a snack or a full meal replacement. Many make the mistake of not making their smoothie filling enough and then get too hungry before their next meal.

Two cups of spinach or kale, two tablespoons of chia seeds or avocado, one small apple, half a cup of berries, almond milk, and a half cup of Greek style yogurt can provide all the necessary nutrients needed to comprise a meal - a fat, a car-bohydrate, and a protein. As a snack, one cup of almond milk, one banana, one and a half cups of spinach, and one scoop of protein powder would suffice.

Sara Fausett RD, CD Clinical and outpatient dietitian for

Intermountain Healthcare at Valley View Medical Center

S W U H E A L T H . O R G 17

PROMOTEHOW COULD YOU GO WRONG? Many think they can never go wrong with a green smoothie because the ingredients are so healthy. That is only partially true. Beware of a few common beginners’ mistakes:

1. Health is not built in a day. Green smoothies can be considered a liquid version of a salad. However, shoving a pineapple, watermelon, apple, pear, avocado, a bunch of celery, a package of spinach, and an entire container of Greek yogurt in a blender may be excessive. They may be healthy calories, but too many for an individual portion.

2. Build it right. If you are making a smoothie to replace a meal, be sure it has a similar amount of calories you would normally eat in a meal. Remember, every meal needs a fat, a carbohydrate, and a protein. The smoothie should hold you over for at least three hours until a small snack can be eaten. If not, reconsider your ingredients or the timing of when you eat it.

3. Watch your sugars to maximize your efforts. If you want to stay full between meals try not to use juice in your smoothie. Juices are generally stripped of the majority of pulp and fiber, so they will not keep you feeling full com-pared to whole produce. They also contain a large amount of sugar which can negatively impact those watching their blood sugars. Whole fruits will take longer to digest than juice due to fiber content, so use these along with a good amount of vegetables. Remember, whole and fresh is best.

4. For some, eating fruits and vegetables can get compli-cated if there are medical issues. For instance, many fresh produce items found in smoothies contain oxalates which can increase the risk for kidney stones for those with previ-ous kidney dysfunction or a family history of kidney stones. Be aware of your individual health limitations and choose foods accordingly.

With the wonderful variety of produce available during the summer season, it’s time to give the green smoothie a try. Refreshing, filling, and healthy, it’s a great way to boost the amount of fruits and vegetables in your diet.

Beginner's Luck

serves 2

Ingredients

2 cups spinach, fresh2 cups cold water1 cup pineapple1 cup mango2 frozen bananas (peeled)

Instructions

Blend spinach and water until smooth. Next, add the remaining fruits and blend again.

For more recipes, visit simplegreensmoothies.com, where you cansign up for their free 30-Day green smoothie challenge!

-green smoothy recipe

The Beginner’s Luck Green Smoothie is a great starter smoothie for be-ginners. It’s full of iron, potassium and vitamins and is sweetened with tropical fruits. Give this smooth-ie a try - you'll be pleasantly sur-prised!

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FOOD FOR THOUGHTBENEFITS OF FAMILY MEALTIME

The Mendenhall family of Cedar City, Utah

Shalyce Oman Health Educator for the SWUPHD

Many families are busier today than ever before, and sharing a meal together often has to compete with long commutes, late work hours, soccer practice, homework and other activities. But when families sit down and eat together, parents and their children benefit in several ways.

Research suggests that children who participate in family mealtime are 24% more likely to eat healthier foods and 12% less likely to be overweight. The average restaurant meal has up to 60% more calories than a home-made meal. Meals prepared and eaten at home are usually more nutritious and healthy. They contain more fruits, veg-etables, and dairy products along with additional nutrients such as fiber, calci-um, and vitamins. Home cooked meals are less likely to be fried or highly salted, and soda and other sweetened beverages have a lower rate of consumption at the dinner table. Eating a home cooked meal is not only more nutritious, it also saves money. Meals purchased away from the home cost many times more than meals prepared in the kitchen.

Children perform better in school when they eat more meals with their families. Teenagers who have family mealtime at least four times per week have a higher grade point average than their peers eating together two times per week or less.

Research also shows that frequent family dinners (five or more per week) are associated with lower rates of smoking, drinking, and illegal drug use in pre-teens and teenagers when compared to families that eat together two times per week or less. Teens who have fewer than three family meals per week are 3.5 times more likely to have abused prescription drugs, 3 times more likely to have used marijuana, 2.5 times more likely to have smoked cigarettes, and 1.5 times more likely to have tried al-

cohol.

The advantages of eating together as a family are obvious, but managing a com-plicated schedule can be a challenge for many families. If five times a week seems unattainable, start with once a week and work up to at least three. When children

are involved in sports or programs during mealtimes, plan to eat dinner when most of the family can be there. A family meal doesn’t need to be gourmet or served in five courses; keep it simple.

Many American families are starved for time spent together. Mealtime may be the only opportunity to put away media de-vices and reconnect with each other. This gives parents a per-fect chance to talk with their children and stay more in tune to what’s going on in their lives.

When families sit down and eat together, parents and their children benefit

in several ways.

S W U H E A L T H . O R G 19

PROMOTE

Liz Edmunds, better known as "The Food Nanny" from the BYUtv reality show of the same name, is passionate about encouraging families to sit down and enjoy dinner together on a regu-lar basis. She knows what she's doing, having raised seven children in a busy household, often at inconvenient distanc-es from supermarkets.

"You often hear about the American family falling apart," Liz says. "The most powerful and natural time in the whole day to gather the family together is at dinner time, and nobody is doing dinner anymore. All kinds of activities are being scheduled through dinnertime. People are eating in their cars on the go and not taking the time to sit down to eat a nu-tritious meal every night and taking the opportunity to talk face to face with their loved ones. The communication and re-lationship is even more important than the nutrition."

So, if a family wants to get back on track, where do they start? "Every family needs

to set a regular dinner hour," says Liz. "Hopefully between 5:00 and 7:30 p.m. The days of having a big noon meal to-gether are long gone and breakfast is too rushed. A regular dinner time provides stability. It's something to look forward to after a long day at school or work, where family members are in a safe place with people who love them. They get to talk about the day and values are taught. It's therapy."

What about conflicting activities? "Don't punish the whole family because a cou-ple of members aren't there," Liz advises. "Set the dinner hour and stick with it. That consistency will result in kids not filling up on junk when they get home because they're looking forward to a home-cooked meal. Set aside a plate for those who come in later and enjoy some interaction with them as well, while they're eating."

Now comes the hardest part: trying to figure out what to eat every night. The solution? Liz recommends a method she has used for over 25 years. "Seven years into my marriage I created a meal plan to make it easy to put dinner on the table on an ongoing basis. It's called Theme Night. Monday is for comfort food, Tues-day is Italian night; fish, meatless, or breakfast on Wednesday, Thursday is Mexican night, Friday is pizza, Satur-day is grilling, and Sunday is tradition night.”

"I realized later that my family was get-ting a great variety of food because I had at least eight recipes to choose from un-der each theme," Liz says. "I also made sure to offer two to three vegetables with each meal; a combination of fresh, fro-zen, or canned , along with fruit." Liz's meal plan takes about ten minutes to up-date. "I do it every two weeks. One week is too short, and a month is too long. Include your family in what meals they want or are craving. Then create your shopping list and go to the store. You'll

start to find you need fewer ingredients when you cook on a consistent basis be-cause you'll have a lot on hand. You can make smaller trips in between for fresh produce. Most everything else you can re-frigerate or freeze."

Liz asserts that families who stick to a simple plan and make regular mealtime a part of their schedule will enjoy a greater quality of life. "If you eat dinner as a fam-ily at least three nights a week, you're go-ing to stick together. Get up to five nights if you can. When your family is bonding over good food, life is good!"

Other words of wisdom from The Food Nanny:

Dessert: "Kids who don't get the chance to eat sweets in moderation often binge on it when they leave home. Prepare des-sert once a week in small portions. I also make cookies or brownies in between."Meat: "I believe it's important to include it in our diet but we could all use less, especially red meat. That's why I have a meatless night and many of my other rec-ipes are meatless as well."Bread: "I cut out bread three times a day. Choose one meal to eat your bread, may-be two on occasion. Try whole grains."Fruits and Veggies: "Most people don't get enough. Serve two to three veggies ev-ery meal. Try new ones often and eventu-ally your family will end up liking them. Try fruit for desserts."Fast Food: "It has it's time and place, just don't eat out all the time. When you go to a restaurant, share your meal or bring home half to eat the next day."Dieting: "Don't eliminate any foods. Most diets don't work long term. What do you love and crave? Make it healthy and prac-tice portion control. Eat a large variety of foods along with plenty of vegetables and fruits. Eat until you're satisfied, not full, then push your plate away. Then you can enjoy a little treat. Soon you won't crave sweets as much."

If the notion of cooking at home with your family most nights seems daunting, take courage from Liz: "When you make your kitchen the heart of your home, you create an experience where you know what's going into your meals. You're chop-ping, handling, smelling the food. There's a connection between body and soul. It's the true life! Your family will be healthi-er, both physically and emotionally."

FAMILY DINNER IS BACKLiz Edmunds is the author of "The Food Nan-ny Rescues Dinner" and "The Food Nanny Rescues Dinner Again!" The Food Nanny airs Wednesdays on BYUtv.

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WALKINGTHROUGH THE AGES

David Heaton Managing Editor

Public Inofrmation Officer for the SWUPHD

Babies get lots of attention when they take their first steps, which are celebrated with applause, cheers, and Facebook posts. The skill of walking is an important one and humans have employed it out of instinct and necessity throughout his-tory to get from one point to another, whether it's across the room or across a continent. We walk around without a second thought, it's automatic. But when is the last time you walked "on purpose"?

Walking for good health is currently highly recommended; it's low-impact, free, and beneficial for the heart, lungs, joints, and mind. You're exposed to nature, fresh air, and sunshine. De-pression and anxiety are reduced, healthy weight is achieved and maintained, and sleep is improved. Done with family, friends, and pets, walking can even strengthen relationships. Fitness guru Jack LaLanne said, "Walk-ing is a big part of my life. If you walk vigorously, it's just as good for you as running." Author Rebecca Solnit adds, "Walking articulates both physical and mental freedom."

The virtues of walking have been known since ancient times. Hippocrates proclaimed, "Walking is man's best medicine." Diogenes coined the Latin phrase solvitur ambulando - "it is solved by walking". A Bulgarian proverb reads, "From walk-ing-something, from sitting-nothing." It turns out sitting is worse than nothing, it's actually linked to early death, espe-cially for those with sitting jobs.

Thomas Jefferson, who took daily long walks throughout his life, was concerned that "the Europeans value themselves on

having subdued the horse to the uses of man. But I doubt whether we have not lost more than we have gained by the use of this animal (replace 'horse' with 'motor vehicle' for our day)." Jefferson also wrote, "I repeat my advice to take a great deal of exercise, and on foot. Health is the first requisite after morality."

Many great authors, artists, musicians, and thinkers made walking part of their routines. Mason Curry, in his book Dai-ly Ritual, found many examples in his research. Beethoven took two-hour long vigorous walks with pencil and music pa-per stuffed in his pocket in case inspiration struck. Sigmund Freud took daily one-hour walks around Vienna at "terrific speed". John Milton spent up to four hours a day walking up and down his garden. Jane Austen took part in frequent walks

with company, a custom often portrayed in her novels. Victor Hugo chose the beach for his daily two-hour walks. For years, Charles Dickens had three-hour walks through London or the coun-tryside. Darwin beat Dickens by half-an-hour in his schedule. Tchaikovsky

walked for thirty minutes in the morning, then two hours later in the day. Louisa May Alcott walked with her family, who were ahead of their time in advocating healthy lifestyles.

Who knows what you will contribute to the world? Why not follow in the footsteps of the great minds of the past and add a daily walk to your schedule? Thomas Jefferson encourages, "No one knows till he (or she) tries how easily the habit of walking is acquired." How easy? Just follow the advice of this Chinese proverb: "One step at a time is good walking."

Why not follow in the foot-steps of the great minds of the past and add a daily walk

to your schedule?

S W U H E A L T H . O R G 21

PROMOTE

An issue as old as time and as common as leaves on a tree, I am often juggling tasks and responsibilities until I can barely remember my own name, let alone the day of the week. When I find myself fighting a losing battle with my sanity I know it’s time to get out of the office, throw on my tennis shoes and “hit the trail.” And my favorite place to sweat it out? The Coal Creek Trail in Cedar City.

According to www.cedarcity.org, the trail runs from Bicentennial Park, north and east past the city ball fields and Rotary Centennial Veterans Park, through East Canyon Park, and east up Cedar Canyon.

What I love about this trail is that it has something to offer everyone. The west, or park, portion of this trail is fairly level and provides a view of community sporting events that can be highly entertaining. The east, or canyon, portion is my favorite as it provides slight inclines, winds its way alongside the creek and is fairly shaded in the evening. This trail is approximately six miles round trip but can be accessed at many points.

Many community members join me in taking advantage of this trail and as I make frequent visits I have begun to make connections and friends with individuals who I enjoy recognizing around town.

Something that keeps me on my toes (literally) is the wildlife that I encounter on this trail. I have to keep an active eye out for lizards that may be sunbathing on the pavement or that run by, momentarily distracting me from a side ache that I may be working through. On this trail I encounter children on bikes, women with babies in strollers, elderly couples and athletes who appear to be training for something far beyond my level of physical comprehension. I never regret time spent outside on this trail and it always leaves me feeling refreshed and ready for a new day at the office.

COAL CREEK TRAIL By Weslie Graham, Managing Editor of Iron County Today

A unique way you can see the beauty of St. George is to travel its trail system which includes mostly paved surfaces. The City of St. George has developed approxi-mately 25 miles of public trails and paths that traverse the city - with plans to add more in the near future.

While you avoid the traffic and stoplights on the road, you can also see and inspect the natural flora and fauna of the area. There are also many services along most of the paths including restrooms, drinking water, shelters, picnic areas, information kiosks and even access to some city parks.

Proper etiquette is greatly appreciated when using the trails. Pedestrians have the ultimate right-of-way, but they are encouraged to readily yield to cyclists and skaters. Travelers should stay to the right and pass on the left while audibly alerting others when passing. Some trails have marked path lines that facilitate the flow of traffic.

These trails offer safe ways to explore the city for pedestrians, runners, cyclists, and skaters. Motorized vehicles are not allowed. Many of the trails are paved while the rest have well groomed natural surfaces. Most are handicap accessible. (source:utahstgeorge.com)

ST. GEORGE TRAIL SYSTEM

For more information on St. George's trails, visit sgcity.org and find Parks & Trails

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Cambree Applegate Former Health Educator for the SWUPHD. She is now the Safe Kids Utah Coordinator

for the Utah Department of Health

FILM REVIEW

In 2012, HBO produced a documentary about the obesity epidemic in the United States, titled Weight of the Na-tion. The film is divided into a four part series, each about an hour long. Watching Weight of the Nation is an eye opening experience that will leave you wanting to jump out of your seat and look for ways you can help yourself, your family,and your community become healthier. You will see the stories of real people who live with obesity and get a glimpse into their everyday lives.

The movie goes beyond giving information and statistics about obesity. You will connect with the people being interviewed and, as you do, the many faces of obesity become very real. The problems people face on a daily

basis are no longer solely consequences of choice, but the result of an environment that America must face as a national crisis.

The tagline “the weight of the nation is out of control, but we can fix that” offers hope that we can change our current behaviors into lifestyles that allow us to be healthier and happier no matter what our circumstances may be. If you enjoy moving and educational films, then take some time to watch Weight of the Nation. You won’t regret it, neither will you be left unchanged.

HBO’s Weight of the Nation is available to view free, online at: https://theweightofthenation.hbo.com/films.

S W U H E A L T H . O R G 23

PROMOTE

CHOLESTEROLUNDERSTANDING THE NUMBERS

Todd Stirling, PA-C SWUPHD Nursing Division Director

Screening for high cholesterol levels can help you understand your risk for heart disease. Experts recommend that men ages 35 and older and women ages 45 and older get screened with a blood test called a lipid panel. It is also recom-mnded that people at high risk for lipid disorders begin screening at age 20. The lipid panel includes:

•Total cholesterol •LDL (low-density lipoprotein choles- terol, also called "bad" cholesterol) •HDL (high-density lipoprotein choles- terol, also called "good" cholesterol) •Triglycerides (fats carried in the blood from the food we eat. Excess calories, alcohol, or sugar in the body are con verted into triglycerides and stored in fat cells throughout the body.)

Results of your blood test will come in the forms of numbers. Here is how to interpret your cholesterol numbers. The first thing you need to know is that the numbers by themselves are not enough to predict your risk of heart problems or to determine what you need to do to low-er that risk. They are, instead, one part of a larger equation that includes your age, your blood pressure, your smoking status, and your use of blood pressure

medicines. Your doctor will use this in-formation to calculate your 10-year risk for serious heart problems. Then the two of you will develop a strategy for reduc-ing that risk.

LDL CHOLESTEROLLDL cholesterol can build up on the walls of your arteries and increase your chances of getting heart disease. That is why LDL cholesterol is referred to as "bad" cholesterol. The lower your LDL cholesterol number, the lower your risk. If your LDL is 190 or more, it is con-sidered very high. Your doctor will most likely recommend a statin in addition to making healthy lifestyle choices. Statins are medicines that can help lower cho-lesterol levels.

You may also need to take a statin even though your LDL level is lower than 190. After figuring your 10-year risk, your doctor will recommend a percentage by which you should try to lower your LDL level through diet, exercise, and medica-tion if necessary.

HDL CHOLESTEROLWhen it comes to HDL cholesterol- "good" cholesterol – a higher number

means lower risk. This is because HDL cholesterol protects against heart disease by taking the "bad" cholesterol out of your blood and keeping it from building up in your arteries. A statin can slightly increase your HDL, as can exercise.

TRIGLYCERIDESTriglycerides are the form in which most fat exists in food and the body. A high triglyceride level has been linked to higher risk of coronary artery disease. Here's the breakdown.

TRIGLYCERIDES TRIGLYCERIDE CATEGORY

Less than 150 Normal150 - 199 Mildly High200 - 499 High500 or higher Very high

TOTAL CHOLESTEROLYour total blood cholesterol is a measure of LDL cholesterol, HDL cholesterol, and other lipid components. Your doctor will use your total cholesterol number when determining your risk for heart disease and how best to manage it.

LIPID PANEL: $35 (Cholesterol screening for risk factors in heart disease. Tests LDL, HDL, triglycerides, and glucose)

A1C: $25 (Tests blood sugar for diabetes control)

PT-INR $25 (Monitors effectiveness of blood-clotting medications like Coumadin)

HEMATOCRIT $15 (Screening for anemia)

Save time and money with these screenings for managing chronic disease

Now at Southwest Utah Public Health Department, St. George and Cedar City Offices (see page 2 for locations)

LOW-COSTHEALTHSCREENINGS FREE BLOOD PRESSURE & BMI WITH EVERY SCREENING!

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CLEARING THE SMOKETHE STORY BEHIND ELECTRONIC CIGARETTES David Heaton

Managing Editor, Public Information Officer

for the SWUPHD

ORIGINSThe "e-cigarette" was actually first conceived in 1963, when Herbert Gilbert invented a smokeless, non-tobacco cigarette. Although Popular Mechanics magazine hailed the battery-pow-ered device as having great potential, the world wasn't ready. Tobacco use had not yet been deemed unhealthy in the United States, where smoking was portrayed favorably in the media and allowed vir-tually everywhere.

Decades later, the market for an alter-native to smoking became more prom-ising. Hon Lik, a Chinese pharmacist and smoker himself, invented a nico-tine inhaler device after his father died from lung cancer. His Ruyan ("like smoke") was marketed in China in 2004 as a cigarette replace-ment and cessation aid.

REGULATORY QUESTIONSThe electronic, or e-cigarette, reached the United States by 2009 and was immediately controversial. The FDA stopped shipments of the product, stating that e-cigarettes were a health hazard and required formal registration. Some states banned them. E-cigarette companies refuted the FDA's claims. Finally, the U.S. Court of Appeals decreed that e-cigarettes were not a drug (unless marketed as such), but could be regulated as a tobacco product by the FDA. This still leaves levels of nicotine and other chemicals in question, although there is now an

effort to impose further regulations on e-cigarettes such as age restrictions, ingredient disclosure, and health warning labels.

In Utah, e-cigarettes fall under the same restrictions as stan-dard cigarettes in the Utah Indoor Clean Air Act, which means they cannot be used in any indoor location accessible

by the public.

ANATOMY OF AN E-CIGARETTEAn e-cigarette is an electronic device which provides inhaled doses of nico-tine and other additives to the user. A rechargeable battery powers an atom-izer, which in turn heats the cartridge containing the "juice". This is a liquid made up of a base (propylene glycol or

glycerin), flavor, nicotine, water and, frequently, many un-known chemicals. The heated juice becomes an aerosol which is inhaled into the lungs, where it becomes condensed and is absorbed into the bloodstream. It is often claimed that users only inhale and exhale water vapor, but the vapor can contain hundreds of different chemicals.

Many e-cigarettes were originally designed to look like nor-mal cigarettes, with an LED that lights up on the end when activated. E-cigs are now marketed in many different shapes, colors, and sizes. The cartridges can be replaced or refilled with a wide variety of flavors. People smoking, or "vaping" e-cigarettes are becoming a more common sight. Small vape

In Utah, e-cigarettes fall under the same restric-tions as standard cigarettes in the Utah Indoor Clean

Air Act.

S W U H E A L T H . O R G 25

PROTECT

1st generation electronic cigarette resembling a tobacco cigarette- one time use

usb charger

1st generation rechargable e-cigarette

tobacco cartridge (mouthpiece)

2nd generation cigarette, available in many shapes and sizes - made for lasting use

cartridges now available in numerous flavors

shops have opened up in many com-munities while big tobacco firms now have e-cigarette subsidiaries. SAFETY AND CESSATIONWhile e-cigarette proponents may suggest the device can help people stop smoking (cessation), there is not yet enough research to determine if this is the case. Anti-smoking advo-cates are concerned that the device may simply provide an additional, less-intrusive method of getting a nicotine fix (dual-use) or encour-age people to get into the habit who wouldn't have been smokers other-wise. They feel the candy and fruit flavors, along with customization options, make the e-cigarette espe-cially attractive to young people. Nicotine is known to be a highly addictive substance which can raise blood pressure and cholesterol lev-els, increase insulin resistance, and be fatal in high doses (10 milligrams is lethal for children). E-cigarette juice containers are not currently re-quired to be childproof, and curious children can be poisoned through ingestion, inhaling, or absorbing the liquid through the skin or eyes. The Utah Poison Control Center report-ed 15 poison calls involving e-ciga-rettes in 2012 and 75 calls in 2013. Since January 2012, over 80 chil-dren under age 6 were sent to Utah hospitals after using the devices.

THE FUTURE OF E-CIGA-RETTESWhile the results of misuse by chil-dren are obvious, the long-term effects of regular adult use on the heart, lungs, and cardiovascular system will remain unknown for some time. Increased regulation is likely. The value of e-cigarettes for cessation or a smoke-free alternative to tobacco cigarettes remains to be seen. Public health officials, while not endorsing e-cigarettes for those purposes, rank the device as poten-tially less harmful to health than cigarettes, chew, and dissolvable to-bacco, but inferior to FDA-approved cessation methods such as nico-tine-replacement patches and gum.

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FIVE SECONDSTEXTING AND DRIVING

Kaysha PriceHealth Educator for the SWUPHD

and Washington County Youth Coalition Advisor.

The average text takes your eyes off the road for nearly five seconds. At highway speeds, that's enough time to travel the length of a football field.

S W U H E A L T H . O R G 27

PROTECT

Five seconds is the average time your eyes leave the road while texting and driving. Five seconds at 55 miles per hour is enough time to cover the length of a football field. At any given moment across America, approximately 660,000 people are using cell-phones while driving. How many of them are texting, distracted five seconds at a time, covering numerous football field lengths without looking?

Text messaging requires visual, manual, and cognitive attention from the driver. All of this attention is compromised while texting. It’s no wonder that the number of people killed in distraction-related crashes in 2011 was over 3,300 and an estimated 421,000 people were injured. The fact is, there are simply too many crashes resulting from texting and driving. It is a habit that’s becoming deadlier than drunk driving.

To curb this deadly behavior, a new Utah law went into effect on May 13th, 2014, prohibiting the use of cellphones, laptops, tablets, or any similar device while operating a motor vehicle. If you are found entering any data onto your device while driving, including writing, reading, or sending a message, dialing a phone number, accessing the internet, or viewing a video, you are breaking the law. While there are some exceptions, including medical emergencies, the best way to avoid a penalty is to simply leave your hands and eyes off of your device while driving . The consequence ranges from a $100 fine to a Class B misdemeanor if someone is injured.

1. Set up Family Rules.

Gather your family together and set rules that work for you. Remind each other of these rules and talk about them often. Be an example to your family by abiding by these rules. Practice with mock scenarios and encourage each other to drive phone-free. Attend a Parent Night, offered at your local high schools through Zero Fatalities and the Southwest Utah Public Health Department. Parent Nights educate new drivers and reminds their parents about dead-ly driving behaviors, along with helping families set guidelines.

2. Stay Focused.

When you’re driving, put your focus on driving. Put away anything that may cause a distraction, especially your phone. Turn off your ringer and put your phone in your briefcase, purse, or pocket. Take advice from a local effort put together by the St. George Police Department: keep your “Heads Up and Thumbs Up”. When you’re driving with your head up and your thumbs up on the steering wheel, then you’re staying focused and paying attention to what’s happeningaround you when driving.

3. Stop It.

Don’t just stop yourself from texting, stop others! If you are in the car with a driver who is texting, re-mind him or her of the hazards. Offer to text for them, or ask them to pull over to finish texting. Fol-low the advice of another local effort, the “Speak Up! Stop the Texts, Stop the Wrecks” campaign, which helps kids realize that they can speak up when they are passengers in a car with a distracted driver.

4.Stay involved.

Support local initiatives. Sign local pledges through the campaigns mentioned above. Take a pledge at distraction.gov, a nationwide effort to stop texting and driving. Decide where you can take action and become an advocate for safe driving. Attend a Zero Fatalities Parent Night. Become informed, then do what you can to help educate those around you.

5. Start with you.

The most important tip is to start with you. Be part of the solution by personally being a safe driver. Make the commitment to drive phone-free today.

The following is a list of five tips to help you (and others) stay safe on the road:

On March 4th, 2013, my parents, Dave & Leslee Henson went on a morning walk on Dixie Drive in St George, UT and were hit by a car while walking on the sidewalk. The driver at fault was texting and speeding. My dad saved my mom's life by taking the full impact and shielding her from the car. My mom survived with a broken neck, broken back, separated shoulder and several other injuries including over 5000 stitches and staples in and on her head. She is a miracle and we are so blessed that she survived the accident. We know she is meant to be here on earth. We hope that together we can save lives by educating teens AND adults on the dangers of distracted driving, most specifically, texting and talking on cell phones while driving. -Haley Warner D

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WHEN THE HOSPITAL IS FULLTHE ROLE OF COMMUNITY INFORMATION & SUPPORT CENTERS

Paulette ValentineSWUPHD Emergency Preparedness

Division Director

It has been well-documented that hav-ing a close connection to neighbors and the community makes a big difference for people involved in the recovery pro-cess after a disaster or emergency. With this in mind, the Southwest Utah Pub-lic Health Department (SWUPHD) Emergency Preparedness and Response Division has been working closely with the Southwest Utah Healthcare Preparedness Coalition and other partners to decide on steps we can take to ensure the best possible recov-ery if something “big” were to happen in our communities. Since healthcare facilities can be easily overwhelmed during disasters, one of the many tools developed in our emergency plan is the Community Infor-mation and Support Center (CISC) concept. The CISC plan began to take shape in 2006 when Mike Leavitt, Secre-tary of Health and Human Services at the time, started talking about the importance of preparing for an influ-enza pandemic. H5N1 (or “Bird Flu”) was becoming a leading cause for con-

cern. Since then, the world has seen the emergence of several new diseases with pandemic potential. Examples in-clude the 2009 H1N1 flu, the MERS coronavirus from the Middle East, and the new H7N9 flu strain currently cir-culating in China. When one of these diseases mutates enough to become

easily contagious, the spread could be rapid and widespread, considering the fact that we live in a global society with frequent international travel. Many of us travel overseas and many foreign tourists make southwest Utah their des-tination. A serious disease outbreak in our area is not out of the question.

As the health department remains vig-

ilant in surveillance efforts to detect and track local disease activity, we also plan for response and recovery should a worst case scenario occur. Since hospi-tals would likely reach full capacity in the event of a large disease outbreak, the CISC was developed to provide essential information and limited sup-

plies to those who might be turned away.

There is a CISC location desig-nated in each of the 43 incor-porated cities or towns in the five counties comprising south-west Utah. They fall under the responsibility of the elected city officials.

When a hospital is getting to the point of “no more room”, local CISCs can be activated.

People unable to get into the hospital will be directed to the CISC, where they will receive specific disease infor-mation and instructions on how to care for themselves or loved ones at home, along with any available medical sup-port supplies. If ill individuals don’t have someone to help care for them once they get home, then their reli-gious organization will be contacted to

Healthcare facilities can be easily overwhelmed during disasters. One of the many tools developed in our communities emergency plan is the Community Information and Sup-port Center concept, to provide es-sential information and limited sup-plies to those who might be turned

away from hospitals.

S W U H E A L T H . O R G 29

PROTECTmake sure they will be checked on and basic needs met. Local units of The Church of Jesus Christ of Latter-Day Saints have agreed to fill this need for those with no religious affiliation. Hopefully, most of us have family, friends, or neighbors who would make sure we had food, water, and support during such an event.

It is comforting to know we live in communi-ties where so many people are willing to help their neighbors during difficult times. We’ve seen this kind of support after natural disas-ters in recent years and would likely see the same spirit of volunteerism and caring during a pandemic.

Want to get more involved in local emergency preparedness?

•Sign up to be a SWUPHD volunteer at www.utahresponds.org (after regis- tering, make sure and click on south- west Utah as your emergency responding area).

•Ask your mayor or city manager about the CISC plan and location for your town or city.

•Join a local CERT (Community Emergency Response Team).

•Assemble a home flu-preparedness kit:

. Boxes of facial tissue (for covering sneezes & coughs, blowing nose)

. Hand Sanitizer (use in between hand washings, when leaving and entering home, sick rooms, etc.)

. Bottles of sports drink (to rehydrate and replenish electrolytes)

. Thermometer (monitoring fever)

. Over-the-counter pain relievers (for treat- ing flu symptom

. Lozenges (to treat sore throat and coughs)

. Respirator masks (“N95” type, use when caring for the sick at close proximity)

. Disinfectant spray or wipes (to disinfect hard surfaces in home, doorknobs, han dles, counters, etc.)

Gather these nine essential items you’ll want to have on hand in case of an emergency:p

lan

1.

2.

3.

4.

5.

6.

7.

8.

9.

water

food

clothes

medications

flashlight

can opener

radio

hygiene items

first aid

9 }

S W U H E A L T H . O R G 31

ADULT IMMUNIZATIONSOCTOBER IS AWARENESS MONTH FOR

SOME THINGS YOU OUTGROW.VACCINES AREN'T ONE OF THEM.

For many adults, vaccinations are a distant childhood memory. Did you know that about 50,000 adults die each year from vaccine-preventable diseases? Vaccines aren't just for kids. Stay current on your vaccina-

tions and keep a personal vaccination record.Talk to your local health department about the vaccines you need. See page 2.

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