Get Healthy Utah News and Blog

Guest Post by Brett McIff

Brett McIff, PhD is the Physical Activity Coordinator for the EPICC Program at the Utah Department of Health.  His research has focused on the perception of the built environment as it pertains to physical activity levels. Find out more about the EPICC Program at www.choosehealth.utah.gov.

Next time you hop in your car to run to the store or drive your child to school, take a moment to think about how things have changed over the past several decades: rates of children walking to school have dropped from 48% in 1969 to 13% in 2009, while more than 85% of adults drive to work every day. As Utah’s demographics, shopping habits, and type of work have evolved, the way we move within our communities has changed as well.

Active transportation is any type of movement that gets you from location to location using your own body as the primary means of locomotion.  Whatever your preference, walking, cycling, even rollerblading–if you are having a flashback to the ‘90’s–all count as forms of active transport.  However, consider how we have engineered ourselves into this current car-focused environment. Schools and workplaces are not always convenient to get to, and in many cases can be quite far away.  Even online shopping puts more vehicles on the road, congesting Utah freeways and streets. All of this engineering, deliberate or otherwise, has an impact on our health.  Heart disease, strokes, diabetes, even certain types of cancer are directly related to the amount of physical activity we do.  As we have decided on the way we want our communities to look, we have inadvertently decided how long we are able to live.

Utah’s public health agencies, healthcare organizations, transportation planning agencies, and elected officials are working together to make active transportation both an easy choice, and a healthy choice.  We are focusing on better street connectivity, protecting pedestrians and cyclists through dedicated paths, and improving the policy environment to better support these behaviors. By doing this, we are not only making our cities more connected by bringing people out of their shells (specifically their cars) but are supporting healthier lifestyles resulting in better quality of life. So, next time as you climb into your car, consider what it would take to change the way you move. Whatever you decide to do, Utah is working together to make it healthier and easier.

Jeff Hummel, MD, MPH
Medical Director, Health Care Informatics, Comagine Health
Meredith Agen, MBA
Vice President, Health Care Analytics, Comagine Health

The COVID-19 pandemic has seemed both distant and confusing to many Americans. Distant because unless one is tracking public health data, it can be difficult to see how this slow motion pandemic is progressing, and confusing because our understanding of the impact of COVID-19 on infected individuals is changing as we learn more about it each week. And it is more complicated than we initially understood.

The extraordinary effort by health care professionals to respond to COVID-19 and the impact of quarantine on patients has also meant that many other health needs such as routine immunizations and chronic illness care are going unmet. As the pandemic progresses, we need to broaden our attention to the additional impacts of deferred care. We must rely on numerous data elements to understand and articulate the importance of preventing, not only the complications of COVID-19, but also the unrelated acute care and chronic illness needs that may be overlooked or exacerbated by the pandemic. We need to creatively use data to monitor and reduce the risk of predictable non-COVID-19 conditions.

The list of non-COVID-19 health conditions that may go untreated during the pandemic is long. In addition to immunizations and chronic disease, it includes such things as behavioral health, domestic violence, pregnancy, frail elderly, substance use disorder, cancer screening and many other topics. A logical way to organize these topics is to specify for each condition what a potentially catastrophic failure would look like, what data flags we might be able to use to tell when patients are in danger and finally, determine what strategies could be put in place to mitigate the risk. The figure below shows such a framework for three such high priority health issues.

Although the types of avoidable events that are potentially catastrophic in the lives of patients will vary by health conditions, there is a clear pattern in the type of data that can be used to monitor for risk of major increases in these events. There is also a clear pattern in the strategies that can be implemented now to mitigate these risks.

Data:

• Enhance aggregation of data for population-based registries that will allow care teams to identify changes in key parameters that indicate a drop off in essential services such as immunizations, physiological parameters like glycemic control, monitoring of daily weight or simply checking in by telephone with a care manager.
• Aggregate refill data to identify situations in which at-risk populations are not refilling crucial medications according to expectation.
• Monitor when there are increases in calls for help to consulting nurses from patients experiencing worrisome symptoms.

Mitigation strategies:

• Immunization administration could be offered at places beyond physician offices and public health departments. Pharmacies already give flu shots and zoster vaccine. Immunization accessibility can be expanded to other settings while assuring strict adherence to both safety protocols and State Registry reporting requirements.
• Most chronic disease outcomes depend heavily on self-management. The effectiveness of peer support networks and community health workers in self-management support has been proven, particularly in the ability to link patients to local community resources. Funding that integrates them with clinical practice sites should be a public policy priority.
• Primary care reimbursement policy should support care management via virtual visits and remote monitoring.
• Data that can be turned into actionable, real-time information is at the core of all risk mitigation strategies.

Get Healthy Utah is proud to have partnered with Comagine Health, Intermountain Healthcare, Utah Department of Health, and University of Utah Health to host the free virtual summit for worksites Improving Employee Health Through Diabetes Prevention: A Lifestyle Change Prevention Program That Works.

Prediabetes affects 1 out of 3 adults. Without intervention, 15-30% of these individuals could develop type 2 diabetes within 5 years. Type 2 diabetes is costly for both employees and employers.

Costs of diabetes:

• Higher COVID-related hospitalizations
• Higher medical costs
• Higher absenteeism
• Lower productivity

Type 2 diabetes is often preventable. The National Diabetes Prevention Program is a CDC recognized evidence-based lifestyle change program that can reduce the risk of developing type 2 diabetes by 58%, decrease the risk of other chronic health conditions, and lower healthcare costs.

Watch the summit recording to learn more about the role that worksites can play in type 2 diabetes prevention and how to best utilize the National Diabetes Prevention Program in your worksite.

Watch: General Sessions HERE

Watch: Type 2 Diabetes in the Workplace 101 Breakout Session HERE

Watch: Integrating Diabetes Prevention Into Your Worksite Wellness Program HERE

Watch: Capitalizing on Your Coverage: How to Get the Most Out of Your National DPP Benefit HERE

Improving Employee Health Through Diabetes Prevention: A Lifestyle Change Prevention Program That Works
Wednesday, October 28th
11am – 1pm

Find the Outreach and Promotional Content Toolkit Here.

Find Speaker Bios Here

Questions? Email This email address is being protected from spambots. You need JavaScript enabled to view it..

Social and economic conditions where we live, work, and play can impact our health status. These include income, affordable housing, safe places to walk, healthy food access, discrimination, and health care coverage. These conditions are connected and impact an individuals’ ability to be healthy. While Utah is typically recognized as one of the healthiest states, disparities exist that make it difficult for all Utahns to reach their full health potential.

Where do these disparities exist?

Economic Stability: Income and employment affect our ability to access healthy foods, make time for physical activity, afford medical care, find adequate housing, and manage stress. Low-income communities often have added barriers such as longer distances to healthy food and low-quality housing. In Utah, rates of poverty are higher among minority populations and individuals living in rural areas. During the COVID-19 pandemic, Hispanics have been hit particularly hard with higher unemployment rates and increased pay cuts.

Neighborhood and Physical Environment: Our built environment, including the transportation system as well as access to parks, trails, and other outdoor spaces impacts our ability to be physically active. When individuals have safe and accessible outdoor space, they have more opportunities to be active and engaged with the community. Research also shows that those who live closer to safe sidewalks, parks, and trails are more likely to be active. At the beginning of the pandemic, Utahns started spending more time outdoors. In fact, visits to parks increased significantly. With the weather getting colder, it can be difficult for all individuals to stay active. Not all Utahns have access to indoor physical activity opportunities such as gyms and recreational facilities. Low-income and communities of color already have greater challenges accessing physical activity opportunities.

Education: Academic support and enrollment in high-quality education leads to longer lifespans, less likelihood of being exposed to violent crime, greater educational attainment, and improved economic opportunity.  Utah schools are offering a variety of learning options including online, hybrid, and in-person. Social interaction for children is limited in order to help slow the spread of COVID. Low-income and families of color have disproportionately faced challenges with educational changes including managing schedule changes, finding child care, and having to stay home instead of going into work to take care of kids.

Food: Nutritious diets are linked to reduced risk of chronic diseases and improved cognitive function. Lower rates of obesity and diabetes are found in areas with increased access to healthy foods. However, many individuals do not have access to healthy food either because they cannot afford it or do not have access to a grocery store that provides healthy food options. During the COVID-19 pandemic rates of food insecurity across the country have increased. Increased unemployment rates have also led to an increased demand at food banks here in Utah.

Community and Social Context: In 2018, Utah ranked 51st in a national analysis of mental health measures by Mental Health America. A number of factors impact mental health including support systems, discrimination, income, and stress. Communities with social cohesion and civic participation have more support networks, social trust, higher rates of physical activity, and reduced stress. The COVID-19 pandemic has understandably caused stress and anxiety among many individuals. Some have lost their jobs, some may be taking care of the sick family members, and many fear the unknown. Maintaining social distancing can also mean that people may feel isolated and unable to have the social support, engagement, or resources that they need.

Health Care System: Access to adequate health care allows people to receive preventive screenings and appropriately manage diseases. A lack of access to a health care facilities, limited provider availability, and lack of health insurance coverage are barriers to accessing care. The COVID-19 pandemic has led to skipped or postponed medical care for nearly 50% of the population. Maintaining proper preventative care is important to reduce further health problems and reduce health care costs down the road.

Moving Forward After COVID-19

COVID-19 did not cause disparities in our communities, but rather highlighted disparities that already existed and will continue to exist. Minority populations have had disproportionately higher case rates as well as hospitalizations related to COVID-19. People with pre-existing medical conditions also have higher COVID-19 related hospitalizations and deaths.

Addressing underlying social determinants of health is critical to improving the conditions that increase the cases and severity of this pandemic. We must ensure that all Utahns have the opportunity to be healthy, now and in the future, by improving the communities where people live.