Issue 13                                                                                          Winter 2023 

Celebrating Martin Luther King Jr. as a Champion of Health Equity

The Healthy Communities team commemorates the life and legacy of Dr. Martin Luther King Jr., a respected and prominent leader in the civil rights movement and advocate for health equity. Dr. King's tenacity and activism paved the way for a more equitable health environment for people of color in the U.S. However, although his profound leadership and involvement in the civil rights movement resulted in monumental progress toward equality, disproportionate health disparities continue to persist for marginalized groups, especially people of color. The Healthy Communities team honors Dr. King's legacy and aims to uplift his message by empowering the community, building partnerships, and continuing to work toward health equity in Snohomish County. 

DOH unveils free teacher resources to bring public health and climate change data into the classroom

Innovative lessons use state data to teach students about issues impacting their communities

OLYMPIA – The Washington State Department of Health (DOH) has announced new educational resources created to introduce students and teachers to public health and climate change data.

Free Professional Development Course In an effort to engage students with local health and climate data, DOH is unveiling a free professional development course for teachers that uses DOH tools and data to explore the connections between asthma and wildfires, which are one of the most obvious impacts of climate change on Washington state.

Teachers who complete the free on-demand course earn eight (8) Science, Technology, Engineering, and Math (STEM) continuing education hours (clock hours) toward their license renewal.

Classroom Learning Modules Washington Tracking Network (WTN) is the nation’s first Environmental Public Health Tracking program to create high school level learning materials. DOH, in partnership with the Puget Sound Educational Service District, is offering free classroom learning materials that lead students through five different lesson plans to give them a unique look at the intersection of climate change and health.

Each module promotes critical thinking by highlighting climate change data, health data, the scientific process, community experience, and insights from epidemiologists. The materials largely pull from WTN’s Information by Location tool, and also include other WTN data. The classroom learning materials are available to anyone for free online.

“Students can dig into areas of health, climate, and socioeconomic data that interest them,” said Lauren Jenks, Environmental Public Health Assistant Secretary. “Using WTN tools and real data, they can see what is most impacting their region, differences between communities, and how factors are interconnected.”

Student Contests DOH’s WTN also offers opportunities for students who want to explore environmental health outside the classroom. The second year of the WTN Youth Science Contest opens for high school students in March, and the Radon Poster Contest for students ages 9 through 14 starts in January.

The Importance of Health Literacy in Health Care

Did you know that 9 out of 10 Americans ages 16 and over have limited health literacy skills? Despite Snohomish County being such a big county, there are many areas where the proportion of the population with low health literacy levels exceeds 40%. Low health literacy levels are a problem that is more prominent among older adults, people of color, people experiencing poverty or homelessness, those with less than a high school diploma or GED level of education, people for whom English is a second language, and people who are refugees and/or immigrants.

Low health literacy has a huge impact on the healthcare system and one of the things it impacts is the economy of the health care system. A study that was referenced in the National Action Plan to Improve Health Literacy estimated that limited health literacy costs the healthcare system somewhere between $106 and $263 billion annually.

There are a myriad of factors which contribute to Americans’ generally low level of health literacy. An individual’s ability to understand English and to communicate with health care providers are two of the main contributing factors to limited health literacy levels. One important barrier to health literacy, which is often under-examined, is the amount of time a physician dedicates to their patient. This includes how much time providers leave for patient questions, how involved a patient is in decisions related to their health, and how often a physician checks for patient understanding. Time spent checking patient understanding isn’t just an important consideration for healthcare providers, but also public health professionals.  

When working with the public, how often do you check for their understanding? When providing health education, simple questions such as “When you talk about this with your family, what will you say?” can ensure our community members are not being left behind.

One great technique to increase health literacy with patients and also create a judgement-free environment is to use the teach-back method. Studies have shown that 40-80% of the medical information patients are told during office visits is forgotten immediately, and nearly half of the information retained is incorrect. The teach-back method is a valuable tool for anyone who shares health information to use with each patient and for all clinic staff to use. The teach-back method is a way of checking understanding without making patients feel judged by asking patients to state in their own words what they need to know or do about their health. There are three steps of the teach-back method. The first step is to chunk and teach information. The second step is to ask patients to teach back what you told them in their own words. Patients can also refer to materials. If the patient is correct when teaching back, then you know that you explained things clearly. If that is not the case, that’s where step three comes in. Step three is to reteach using different words and techniques such as pictures, videos, etc. This method can help improve patient understanding and adherence, decrease call-backs and cancelled appointments, and improve patient satisfaction and outcomes.

Together, we have the power to make a difference. Increased levels of awareness, implementation of training, and incorporation of best practices relating to health literacy are just a few of the ways you can help. Another way to help is by increasing your knowledge about the rates of health literacy nationally and state-wide. Here is a resource which geographically shows health literacy levels: US Health Literacy Scores (unc.edu). 

Fentanyl Exposure Safety

Misinformation surrounding second-hand fentanyl exposure can cause fear that prevents or delays people from taking life-saving action to help someone who is overdosing. Reversing an overdose is a time-sensitive intervention, and the sooner we can intervene the better the outcome will be. 

You are not at risk of an overdose if you help someone who is overdosing on fentanyl. 

It is effectively impossible to overdose from touching fentanyl. Fentanyl must enter the bloodstream for a person to be affected by it. Fentanyl is not very water-soluble and does not pass through the skin easily. Fentanyl patches are specially designed to allow fentanyl to pass through the skin. According to the American College of Medical Toxicology, if a person’s hand was covered in fentanyl patches it would take 14 minutes to receive a 100-mcg dose (1). This is a commonly prescribed dose amount for pain management in outpatient treatment (after surgery for example). This demonstrates that even with technology to help absorb fentanyl into the skin, significant exposure to fentanyl on the skin isn’t a cause of concern for overdose, especially over short periods of time.  Medical staff has also reported spilling liquid fentanyl on their skin, with no effects. If you do get fentanyl on your hands/ body, do not use sanitizer or any other alcohol-based products, as this can aid in absorption. Instead, wash the area with soap and water.

Fentanyl is absorbed most efficiently through mucous membranes (eyes, nose, mouth). However, it is very unlikely that fentanyl will come in contact with a person’s face by accident. To protect yourself further you can use eye protection such as goggles, although these are not required (1). Additionally, avoid touching your face when you are responding to an overdose where fentanyl may be present. After responding to an overdose, wash your hands with soap and water before touching your face or eating/drinking anything.

Inhaling secondhand fentanyl smoke or powder fentanyl is also not a concern for overdose. Fentanyl does not linger in second-hand smoke, because the person smoking the fentanyl receives the majority of the substance (1). Powder fentanyl also does not easily become particles in the air. If there are fentanyl particles in the air, they are very small, and it would take 3.5 hours (without any respiratory protection) for the body to accumulate a detectable amount of fentanyl (2).

If you do believe someone is experiencing a fentanyl overdose, look for signs of an overdose:

• Pale/ clammy skin
• Not breathing or very shallow breathing
• Deep snoring or gurgling noises
• Unresponsive to someone calling their name, shaking them, or a breastbone rub (use your knuckles and rub them into a person’s breastbone, also called a sternum)
• Slowed heartbeat/ pulse
• Blue or ashy coloring around their fingertips or lips. Typically, people with whiter skin complexions will have blue coloring and people with darker skin complexions will have ashy coloring.