Summary of the Encouraging Healthy Behaviors Critical Issue Session
Seattle: Regions VIII and X
December 2, 1998
Moderator:
Paul Coates, PhD
Deputy Director, Division of Nutrition Research Coordination
Panelists:
Alana Knudson-Buresh, PhD
Chief, Preventive Health Section
The topic for her presentation was "North Dakota Youth Health Behaviors." Surveys were described that revealed 20% of high schoolers surveyed were smoking cigarettes, and 23% of males were using chewing tobacco and snuff. 61% of high schoolers surveyed has used alcohol in the thirty days prior to the survey and 42% had participated in binge drinking. Driving after drinking was reported by 33% of them. This is the highest in the nation and is twice the national average.
With regard to sexual behavior, 39% of the high schoolers surveyed reported experience with intercourse and 52% of those claimed to have used condoms. The pregnancy rate of ND teens the lowest in the US. Male partners average 3.3 years older than the female partners.
Suicide is increasing on an annual basis. 38% of males and 22% of females reported physical fight involvement during the previous year. Only 17% of students reported always using a seatbelt.
Physical activity questions revealed that 60% of students engage in regular aerobic activities, 50% attended physical education classes at least once per week, and 30% had daily physical education.
Dietary survey questions revealed that one-third of students considered themselves to be overweight, 26% of males and 42% of females. 50% of the students reported attempting to lose weight, 24% of males and 68% of females.
Discussion of solutions to these health issues is important and the
school system should be involved as well as community organizations. It was noted that sometimes parents are part of the problem and the example given was that some parents buy cigarettes for their children.
Fred Garcia, MSW
Chief, Office of Program Services, Division of Alcohol and Substance Abuse
Mr. Garcia shared information about his work and the challenges that exist with attempting to address the large problems of alcohol and substance abuse.
One out of ten adults in Washington state were reported to require chemical dependency treatment over the last year. 75% of low income adults who need treatment did not receive it. Absence of treatment is associated with an increase in fetal death rates. Those who receive treatment for CD have a fetal death rate of 4.5 compared to 14.5 for the no treatment group.
Adolescent alcohol use and sexual activity, and bringing of weapons to school are associated. Adolescent drug use is associated with increased suicide rates. 52% of arrested male adolescents and 47% of arrested female adolescents have diagnosable substance abuse disorders. Absence of treatment is associated with higher arrest rates and worsened school performance.
The lower infant birth weights that occur in conjunction with maternal substance abuse increases the medical costs by $1,753.00 per infant. Treatment of the mothers therefore saves the system money.
The costs for treating the mentally ill chemically addicted was over $2 million for 534 clients. The cost savings would be tremendous if prevention avoided these addictions.
He made the point that there is a need for the individual health care professional to work one-on-one with clients in a "priest" capacity, but there is also a need for the professional who act to set policy in the "prophet" capacity. The environmental prevention strategy must include media literacy programs, and the involvement of individuals, groups and systems to address the issues.
Examples of how our youth are targeted for unhealthy behaviors included temporary tattoos found in a toy store that had a picture of Tweety-bird with a marijuana joint in its beak, and the popular group Spice Girls whose musical lyrics include a lot of sexuality emphasis, and whose main audience is 11-13 year old girls.
Susan Soule, MA
Rural Services Coordinator
Alaska Division of Alcoholism and Drug Abuse
Ms. Soule spoke about the problem of suicide in Alaska and the public health approach that is seeing some results with regard to decreasing the incidence of adolescent suicide. As Alaska is so big with a lack of roads to many of the villages, the challenges for addressing problems from a remote location required unique solutions. The rate of suicide for the state of Alaska is 24 per 100,000 and 48 per 100,000 for Alaskan Natives. This is compared to 11-12 per 100,000 for the U.S. In an attempt to address this huge problem they received grants to allow them to train local workers or coordinators for the villages suffering from the high suicide rates. The local workers attend five-day training sessions and use their knowledge to create sober, healthy, life-affirming events and activities for the young people of the village. Examples include the following:
Villages who have instituted these projects have been seeing a drop in suicide rates. The concept of those who commit suicide being mentally ill was addressed. The speaker objected to the inclusion of suicide HP 2010 goals in the mental health chapter because many of those who commit suicide are not mentally ill in her opinion. Rather they have hopeless, helpless feelings, despair and difficult lives. Added to that is the use of alcohol and the ready available of guns. The hope is that the suicide rates will continue to drop as the communities continue with these projects to address grief work and to create life-affirming relationships and activities.
Joan Ware, MSPH
Director, Utah Cardiovascular Health Program
Ms. Ware outlined a recent project called the five-a-day program that targeted nutrition approaches to reducing cardiovascular risk factors in Utah. She provided a framework for her talk that described skills that public health needs to develop in order to be effective.
Discussion Summary: