HomeMy WebLinkAbout10/03/2011 Work Session
City of Springfield
• Work Session Meeting
MINUTES OF THE WORK SESSION MEETING OF
THE SPRINGFIELD CITY COUNCIL HELD
MONDAY, OCTOBER 3, 2011
The City of Springfield Council met in a work session in the Jesse Maine Meeting Room, 225 Fifth
Street, Springfield, Oregon, on Monday, October 3, 2011 at 6:05 p.m., with Mayor Lundberg
presiding.
ATTENDANCE
Present we're Mayor Lundberg and Councilors VanGordon,. Wylie, Moore, and Woodrow. Also
present were City Manager Gino Grimaldi, Assistant City Attorney Mary Bridget Smith, City
Recorder Amy Sowa and members of the staff.
Councilors Ralston and Pishioneri were absent (excused).
1. Using Public and Organizational Policies to Improve Community Health.
City Manager Gino Grimaldi presented this item. He introduced Dr. Patrick Luedtke, MD, MPH, Lane
County's Public Health Officer and Medical Director, for the Community Health Centers of Lane
County and Jennifer Jordan, MPH, Program Coordinator for Chronic Disease Prevention at Lane
County Public Health, who were here to present information to the Council regarding public and
• organizational policies that made our community a healthier place to live. He reminded Council of
past discussions regarding public health that had been of interest to the Council, making this topic very
timely.
Health Problem: 7 out of 10 deaths among Americans each year are from chronic diseases. Heart
disease, cancer and stroke account for more than 50% of all deaths each year (National Vital Statistics
Reports, 2008). In 2005, 133 million Americans - almost 1 out of every 2 adults - had at least one
chronic illness (RAND Health, 2000).
Financial Impact: More than 75% of our local health care dollar is spent treating chronic diseases.
Causes: Four modifiable health risk behaviors-lack of physical activity, poor nutrition, tobacco use,
and excessive alcohol consumption-are responsible for much of the illness, suffering, and early death
related to chronic diseases (US Centers for Disease Control and Prevention, 2011).
Local Solutions recommended by the US Centers for Disease Control and Prevention: Lane
County Public Health's Chronic Disease Prevention Team's efforts focus on local public and
organizational policy, systems and environmental change initiatives that protect people from exposure
to second hand smoke and increase access to healthy food and opportunities for physical activity.
Dr. Luedtke provided a power point presentation on this topic. He gave an overview of the four issues
he would be discussing. These topics were:
• Threats to and the current state of the public's health
• Affecting public health: Policy, systems & environmental changes
• • Chronic disease prevention at Lane County Public Health
? Tobacco prevention
,a
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Council Work Session Minutes
October 3, 2011
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Obesity prevention
• Center for Disease Control (CDC)-funded collaborative ACHIEVE initiative
Dr. Luedtke said for many years public health focused on clean water, clean food, and outbreak
responses. Over the last 30 years, they had seen a large increase in chronic disease and chronic disease
expenditures in our health care system. As the research had matured, they had seen quite a bit of
change in the needs to respond to the problems.. Today's children would likely be the first generation
in about 150 years whose life expectancy would be shorter than their parents. Obesity was in epidemic
proportions among children. He spoke regarding smoking and noted that the problems with smoking
were still prevalent in our society. Obesity wasn't just caused by food, but could also be from being
sedentary. Policy issues that prevented people from having an environment where they could safely
walk could also contribute to obesity.
Councilor Moore noted a newspaper article regarding the money saved for the individual and the
citizenry as a whole when people quit smoking.
Dr. Luedtke said the leading causes of death nationally included heart disease, cancer, stroke, chronic
lower respiratory, unintentional injuries, diabetes, Alzheimer's disease, and pneumonia/influenza. He
noted the top four chronic diseases were majorly affected by smoking. In Oregon, and Lane County,
tobacco was the leading cause of death. Obesity was also a major cause of diabetes which was one of
the leading causes of heart disease, cancer and stroke. Because of these statistics, Lane County Health
focused on obesity and tobacco use. Both were preventable and both were modifiable. They could be
modifiable by individuals and also by policies and system changes that could be put into place from a
• governmental standpoint to improve the playing field in which people lived. Lane County had
substantial data demonstrating that doing policy, system, and environmental changes could make a
difference without impacting too much on person liberties. He provided data specific to Lane County
regarding tobacco use and obesity.
Councilor Moore said she recently saw someone using chewing tobacco. She asked if that was in the
same data under tobacco use.
Ms. Jordan listed some of the many forms of oral tobacco products. These products were created for
people in areas where they couldn't smoke. All products were tobacco products, and although there
was. no long term study on those products, they were likely harmful. Nicotine replacements to assist
people to quit smoking were different and were recommended by the FDA.
Councilor Wylie said when she served as the Director of Willamette Family Services, she had several
co-workers who smoked and eventually died of cancer due to tobacco use.
Dr. Luedtke said the oral forms also caused different types of cancer.
Councilor VanGordon asked about the 15% of 11 tb graders who smoked. He asked if that figure rolled
over into the adult statistics.
Ms. Jordan said they didn't have longitudal data on the younger subjects. Usually if someone started
smoking when young, they continued.to smoke into adulthood.
• Councilor VanGordon asked what was considered a regular smoker. If they were occasional, did that
help with the strategy of prevention?
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Council Work Session Minutes
October 3,2011
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•
Ms. Jordan said this was a state study and she was not sure about the definition for regularly. She.
thought it was probably more than once a week. Most tobacco users started before they were under the
age of 18.
Councilor VanGordon asked about the lost revenue figures for Lane County.
Ms. Jordan explained the figure in productivity lost and what factors were considered. Smokers cost
employers about $5400 per year per smoker.
Further discussion was held regarding the figures related to productivity lost and death.
Dr. Luedtke said the dollar figures were interesting. There were many measures showing how health
tied in to work productivity. Smokers took $127M out of the economy which could be better spent
elsewhere. He spoke regarding obesity and the numbers in Lane County. Adults and children were not
getting enough fruit and vegetables, and were not getting adequate physical activity. He referred to a
series of slides regarding obesity. figures since 1990. There had been significant changes and increases
in those figures over the last 20 years. There were many societal and environmental factors that led to
obesity. Fast food venues were much more prevalent today and it was often more difficult to get
exercise.
Councilor Moore said advertising and high fructose corn syrup had added to the problem.
Dr. Luedtke said the United States had promoted corn in many foods and in other areas, such as fuels.
• There were policy, system and environmental changes that could be put into place that could make our
communities healthier in those areas.
Councilor Wylie said Oregon was second in the nation for drug abuse and was high in alcohol abuse,
suicide rates, and mental health issues.
Dr. Luedtke said there were members of the public who might argue environmental factors, such as
toxics. Our culture had changed the environment to create obesity; it was not a physical change.
Councilor VanGordon asked how income played in this.
Dr. Luedtke said there was a clear correlation between socio economic status (SES) and obesity, but
all SES classes had become more obese over the twenty year time frame, and were growing about the
same rate. Some things were being done. Schools often had community or school gardens, City's had
farmer's markets, and there was. a focus in the community placed on outdoor activity. More could be
done. The Centers for Disease Control tried to help public health focus on areas where we could make
the biggest change. The old public health arena included counseling and education, but mainly reached
those interested rather than those that needed the information. A good deal of the changes needed to
take place at the City or County level by making policy, system and environmental changes. Policy
changes could be formal or informal, governmental or non-governmental, such as non-profits or large
employers. Environmental changes were physical or material changes, such as making safer walking
areas, or building walking or bike paths that connected main areas. Some successful environmental
changes in our area included the Eugene Pedestrian and Bicycle Strategic Planning work and the
Springfield Farmer's Market. System changes worked to change social norms, such as the movement
. to buy local foods.
Councilor Moore noted the recent deaths from the contaminated cantaloupe from Colorado.
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•
Dr. Luedtke noted other bacteria that affected our food. Other system changes included connectivity
issues, clinical guideline implementation, chronic disease management, and mixed and joint use
policies. Some of those policies included schools celebrating nutrition month, community work-site
hospitals holding free breast feeding courses for new moms, and implementing baby friendly health
system policies. Each of those could make a difference long-term if done correctly and made
permanent. The National Institute of Medicine had the following quote, "It is unreasonable to expect
that people will change their behavior easily when so many forces in the social, cultural; and physical
environment conspire against such change". He spoke regarding the amount of money spent on
advertising for foods and sodas.
Ms. Jordan said by January 4 of each year, the soda industry had out-spent the entire amount spent by
the Federal Government for nutrition promotion.
Dr. Luedtke quoted the CDC, "Key decisions rest in the hands of local decision-makers. Community
mobilization will be crucial in reversing the looming crises in national chronic disease burden and
health disparities. Recognizing this, the CDC, state and local health departments, national
organizations with extensive community reach, and a wide range of local leaders and organizations are
collaborating to focus, activate, support and spread local change across our nation". He reiterated that
60% of all deaths in this country were from the top four diseases, and smoking and obesity were the
number one and two causes for those diseases. Also, 75% of'every health care dollar spent in the
United States was on chronic diseases.
• Councilor Moore said if these figures related to viruses, there would be an uprising.
Dr. Luedtke said there were personal liberties involved in these issues, but there was a cost to society.
Ms. Jordan said at the County Health Department they had a tobacco prevention program which had
been in operation since 1997. They also had a small obesity prevention program since 2005. There
were two staff: one tobacco person and one part-time obesity person who applied for grants to expand
the work (Ms. Jordan). She referred to a slide showing policy successes in Lane County. Many of the
local successes had moved on to become state laws, and.some could become national laws. One of the
latest trends they were seeing was smoke-free workplaces: Lane County departments were becoming
smoke free campuses, and there was more interest from many work-sites.
Councilor Wylie said that was good news to hear. She had wanted that at Willamette Family while
serving as Executive Director, but faced opposition by key managers who smoked.
Ms. Jordan said Lane County Public Health helped people to move this policy forward in their
workplace. Another policy passed last year was the Housing and Public Housing policy banning
smoking inside all of their public housing units. They were working with Lane Community College
(LCC) who has limited their smoking. The University of Oregon was committed to a tobacco-free
campus by fall of 2012.
Councilor VanGordon asked how tobacco bans corresponded with tobacco usage
Ms. Jordan said one of the side effects was that people that wanted to quit found.it easier when at a
• smoke-free workplace. The main reason for implementing the bans was to prevent exposure to second-
hand smoke. In 2006, the Surgeon General reported that there was no risk-free level of second-hand
smoke. They were seeing more bans outside of restaurants. About 50,000 people died each year in the
•
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October 3, 2011
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United States from second-hand smoke exposure. The bulk of their policy success was in the area of
tobacco because of longevity and funding of the program. Many community partners had been
involved in making this a success. Obesity Prevention had been moved more to chronic disease
management due to funding issues. Oregon didn't have federal funds for obesity, and had not put
funding in for obesity prevention. A menu labeling initiative was brought to the Board of County
Commissioners in 2009, which was pre-empted by a weaker statewide law, which was now pre-
empted by a federal law. She had worked at a lot of worksite wellness promotion initiatives,
encouraging healthy foods at meetings and events. Other ways to encourage a healthier workforce was
to find healthier items for vending machines, encouraging employers about the benefits of alternative
transportation and flexible work schedules. In their own work group, they encouraged staff to get
recommended health screenings. In an effort to build the program, Ms. Jordan had written a lot of
grants and worked with the local obesity prevention non-profit, the Lane County Coalition for Health
and Active Youth.
Ms. Jordan spoke regarding a grant for the ACHIEVE initiative. Lane County was the fourth cohort
out of forty nationally to go through this. Some of the funding was from the Center for Disease
Control and Prevention and administered by a small non-profit that provided technical support for this
work. They were working with many partners in the community to do assessments of our local
policies and environments. Once the assessment data was complete, the coalition would go back to
their partners,. working to find interest in creating a community plan to address problems.identified.
They were working to prevent chronic disease, improve overall community health, increase social
justice and health equity, and improve health of local workforce. This work could have an impact on
health related costs. They were working to build relationships in the community. The identified
coaches, including Ms. Jordan as head coach, attended a coaches meeting and pulled together a
community health action and response team of ten to go to a week-long training in Baltimore. This
was a long-term commitment and was very complex. With their community team, they had done a
series of assessments; one of the community at-large with Lane County, and had committed to doing
one with the City of Springfield. They had done an assessment of PeaceHealth Oregon region as a
.whole, and also looked at the Community Health Centers of Lane County, including RiverStone in
Springfield. She noted some of the other worksites they had visited. It was challenging to figure out
how this all fit into each agency.
Mayor Lundberg asked if Council had any questions. She asked what Dr. Luedtke and Ms. Jordan
would like from the Council.
Ms. Jordan said they had completed a majority of assessments and would like to complete the
assessment for Springfield.
Councilor Woodrow said she was cynical of some of the data, but was supportive of what they were
looking for. She noted an issue when someone's death was listed as tobacco related when it was not
and felt sometimes the data was skewed. She also noted the change in the definition of obesity. She
said high fructose syrup was basically a sugar which everyone needed to watch. She had seen studies
on places that had put bans or taxes on soda that showed it was not working. She grew up with a .
garden and fresh food and loved that and wished everyone could have that, but she was concerned
about social engineering. She would like to see weekly flyers with recipes sent home to families to
show them how to make healthy choices economically, rather than forcing them by law or default.
Default only lasted one generation.
Dr. Luedtke said he shared some of her skepticism. The information they presented was a continuum.
When they changed the definition of obesity in the 1980's, they learned that there were different
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Council Work Session Minutes
October 3, 2011
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factors and had made changes. They were now focusing on policy, system and environmental change
due to limited staffing. If they could go out with their limited staffing and set up a policy for no-
smoking, they could affectively change 1200 people's exposure to tobacco.
Councilor Woodrow said she had no problem with that.
Dr. Luedtke said they had good data showing the number of asthma attacks prevented, number of
emergency room visits decreased, and amount of lost time for students decreased.
Councilor Woodrow said she was a cynic, but was open to information. She noted other examples of
things that needed to be thought out before made policies.
Mayor'Lundberg said what they were working on was very valuable. They were looking for a healthier
community because healthier people were happier. She noted the healthy food carts at the Dari Mart,
and said that was a good example of making healthy choices convenient and affordable. There were
many things we could do to encourage a healthier lifestyle, such as nice playgrounds for our children,
without being punitive or negative. Springfield's participation as policy makers would be to look at
what could be done. Small things made huge differences over a long period of time. She would love
to see all Dari Marts with the open farm stand.
Councilor Moore noted the NEDCO community kitchen.
Councilor VanGordon said they were all looking for easy things that could be done because there was
not a lot of money. It would be helpful if they could get a list of things the City could work on over
time. The Fire Department could speak on chronic disease related to ambulance calls.
Councilor Wylie said she would like to see some of these issues on the TEAM Springfield agenda.
Working together they could sponsor events such as walks, runs and bicycle rides that could get whole
families involved. .
ADJOURNMENT
The meeting was adjourned at 7:07 p.m.
Minutes Recorder - Amy Sowa
Christine L. Lundberg
Mayor
Attest: ..
Amy So &
City Recorder
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