Southeast Missouri health check-up: Health assessments look at local issues

EDITOR'S NOTE: The following story appears in Healthwatch magazine, which will appear in the Sunday, June 27 Southeast Missourian.

The Missouri Department of Health and Senior Services requires all health departments to complete regular Community Health Assessments. With this data in mind, departments create programs to boost health and health awareness in their communities. Obesity, smoking, heart disease and diabetes top the lists this year. Public health experts share how they're addressing the issues in Southeast Missouri.

BOLLINGER COUNTY

In Bollinger County, the most pressing health issues are heart disease and all factors leading up to it, including smoking, obesity and a lack of exercise. The problem is that because those factors are already ingrained in the population's lifestyle, they are very difficult to change, says Beverly Piepenbrok, administrator at the Bollinger County Health Department in Marble Hill, Mo. To ease this process, the department is working to bring health resources and information closer to the rural community and surrounding areas.

"We're trying to go where the need is," says Piepenbrok. "Traveling to Cape is not that big of a deal, but with gas prices and unemployment rates, it's becoming more important to have this locally."

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Most recently, a Bollinger County health educator was trained by the American Lung Association to lead smoking cessation courses in Marble Hill and nearby communities, including Zalma, Mo. A sidewalk was built around Twin City Park a few years ago, and a playground was added this year. Piepenbrok says she is amazed by all the people exercising in the park, where eight laps equals about a mile. Now that there is a playground in the center, she adds, parents can watch their children play and get a workout at the same time. The health department also has a treadmill available for free community use at First Baptist Church.

The department offers several chronic disease prevention programs, including arthritis exercise sessions and "Kids in the Kitchen" classes to teach children kitchen safety and how to make wise food and lifestyle choices. Attendees even sample healthy foods they may not have tried before, such as broccoli and cauliflower or star fruit, pomegranate and papaya.

Bollinger County is also working with the Missouri Department of Health and Senior Services to make sure newborns are sleeping in safe cribs. In the spring, the department promoted and held clinics for the TDap (tetanus, diphtheria and pertussis) vaccine, a new requirement for students entering eighth grade this fall.

BUTLER COUNTY

Robert Hudson, administrator for the Butler County Health Department in Poplar Bluff, Mo., says the county's top health concerns are obesity, tobacco use and chronic diseases like diabetes and heart disease. More specifically, Hudson says the department has seen an increase in childhood obesity and the number of women smoking while pregnant.

"We need the will to change and the resources to help make those changes," says Hudson. Unfortunately, says Hudson, the economy has taken a toll on the county's overall health -- not only is less funding available to the health department, but he believes residents are turning to stress-related habits like smoking and overeating, contributing to even more health problems.

"A lot of times it loops back to socioeconomic status and stress levels causing people to fall back on those vices," says Hudson.

Targeting obesity, the department is traveling to local schools to measure students' body mass index, speak to youngsters about exercise and healthy eating and conduct taste tests on healthy foods, from baby carrots to kiwi fruit. Hudson adds that the department is working with schools to offer more fresh fruits and vegetables at lunchtime.

The department is addressing the smoking issue primarily through its Women, Infants and Children clinic, where professionals speak one-on-one with mothers about health care during pregnancy and how smoking affects their bodies and that of their unborn child, says Hudson.

While finances remain tight for the health department as well as its community members, Hudson stresses the importance of healthy eating and regular exercise. He recommends planting a garden for fresh food as well as exercise, and taking a daily walk to improve health and lower stress levels. Even a short walk is beneficial, he says.

"It's the minor things that don't make a tremendous impact on the pocketbook -- but small changes can make a big difference," says Hudson.

CAPE GIRARDEAU COUNTY

The Cape Girardeau County Public Health Center in Cape Girardeau has identified three big health problems for its population: overweight and obesity, chronic diseases and smoking during pregnancy. The department has decided to tackle obesity -- especially childhood obesity -- first, as it so often contributes to the chronic diseases like heart disease and diabetes, explains Charlotte Craig, director of the health center.

"We decided to zero in on obesity," says Craig. "If you take on too much you're not going to be successful at any project. These are all monumental issues."

The department has already purchased a Coordinated Approach to Childhood Health program for preschool-age children, which Craig describes as a ready-made curriculum to teach information about nutrition and physical activity. The center is also working through its maternal child health program and local schools and daycares to assess childhood obesity in Cape Girardeau County.

"School nurses are in agreement that obesity is a problem," says Craig. Together, schools and the health department are looking for possible solutions and grant funds.

As for smoking during pregnancy, Craig admits the increased rates in Southeast Missouri are "mind-boggling," especially considering the high cost of cigarettes and the huge amount of information available about the dangers of smoking.

"It's an expensive habit in several ways, including the mother's health and the baby's health," says Craig. The health department will continue to address this issue through its WIC program, where health and smoking information are "repeated and reiterated" and smoking cessation programs are available, says Craig.

SCOTT COUNTY

The biggest health issues in Scott County are tobacco use, teen pregnancy and chronic diseases, says Barry Cook, administrator for the Scott County Health Department in Sikeston, Mo. While the county fares decently within the Bootheel, Cook says it consistently ranks worse compared to the state, and that's something the department hopes to change. Like other local health departments, Scott County has found that the best place to start is in the local schools.

"I think that's the best way to go. The health department is here for the long run, not the short run," says Cook. "It's been proven over the years that if we teach kids healthy habits, they'll carry them on as adults."

The department is continuing Smokebusters, a statewide program focusing on peer education to prevent smoking. Under this program, health educators like Brenda Freed teach students about the dangers of tobacco use, then teach them to pass the word along to the public, community organizations and other students. According to Cook, the department is now expanding this program to include both smoking prevention and cessation.

In hopes of cutting down on teen pregnancy and childhood obesity, Freed also visits schools to discuss sexually transmitted diseases, pregnancy, healthy eating and exercise. Says Cook, the department offers a low-cost family planning clinic and will continue to spread the word about its services.